Evaluation the effect of intravitreal ranibizumab and aflibercept therapy on anatomical and visual results in pigment epithelial detachment (PED) secondary to age-related macular degeneration (AMD)

Purpose: To evaluate the effect of intravitreal ranibizumab and aflibercept therapy on anatomical and visual results in pigment epithelial detachment (PED) secondary to age-related macular degeneration (AMD). Materials and Methods: The 98 eyes of 87 patients who had PED secondary to AMD, treated with intravitreal ranibizumab or aflibercept as monotherapy or consecutive therapy were evaluated retrospectively. Best corrected visual acuity (BCVA) evaluated on the Snellen chart, intraocular pressure (IOP), central macular thickness (CMT), lesion type and width, PED height and width, subtype of PED measured with the optical coherence tomography (OCT), number of injections, follow-up duration and number of visits were assessed using patient medical and imaging system records. Baseline and follow-up findings were compared. Results: Out of 87 patients, 41 were female (47.2%), 46 were male (52.8%). The mean age at diagnosis was 69,05 ± 8.54 (50-88) years old. While the mean baseline BCVA was 0.887 ± 0.655 LogMAR, at the end of the follow-up period, it was 0.847±0.614 LogMAR. Among the all PEDs, 34 (34.6%) cases were fibrovascular, 32 (32.6%) were serous, 19 (19.3%) were hemorrhagic and 13 (13.2%) cases were drusenoid. The mean baseline PED height was 278.26 ± 171.49 (113-920) microns; at the end of the followup period, the mean PED width was 2547.231±1201.881 (184-5902). Out of 98 eyes, 39 (39.7%) were treated with ranibizumab, 47 (47.9%) eyes were treated with aflibercept and 12 (12.2%) eyes were treated with anti-VEGF agents. x At the end of the follow-up period, scar and atrophy formation were seen in both groups. Complication rate was higher in PEDs with the lesion greater than 50%. RPE ruptures were seen in 18 of 82 eyes with the PEDs having lesion greater than 50%. Conclusion: While BCVA increased in the first two years, there was a decrease in BCVA in the subsequent follow-up visits. There was a meaningful decrease in PED width comparing baseline versus 6 months, but no decrease comparing baseline vs 12- months follow-up assesment. PED height decreased significantly at 12-months followup from the baseline evaluation. There was a higher percentage of RPE ruptures in PEDs with the lesions above 50%. The scar and atrophy development were determined as the notable factors in visual prognosis