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Vitreomacular Interface after Anti-Vascular Endothelial Growth Factor Injections in Neovascular Age-Related Macular Degeneration.
Ophthalmology 2015; 122(8):1569-72O

Abstract

PURPOSE

To evaluate the incidence of posterior vitreous detachment (PVD) induced by intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents in cases of neovascular age-related macular degeneration (AMD).

DESIGN

Cohort study conducted at a single tertiary referral vitreoretinal practice.

PARTICIPANTS

A total of 396 eyes of 295 patients were diagnosed with neovascular AMD between 2009 and 2014. A total of 125 eyes of 112 patients met the inclusion criteria and were evaluated in this study.

METHODS

This study included patients with neovascular AMD who presented vitreomacular adhesion (VMA) detected by spectral-domain optical coherence tomography (OCT) at baseline. Eyes with VMA were classified according to the diameter of vitreous attachment to the macular surface measured by OCT, with attachment of ≤1500 μm defined as focal and attachment of >1500 μm defined as broad. All patients received at least 3 monthly intravitreal injections of anti-VEGF agents. Follow-up visits were performed 1 month after each intravitreal injection and included OCT analysis to evaluate the incidence of PVD.

MAIN OUTCOME MEASURES

Posterior vitreous detachment induced by anti-VEGF injections.

RESULTS

The mean follow-up period was 21.3 months (range, 3-59 months). The mean number of intravitreal injections was 8.3 (range, 3-29 injections). Intravitreal drugs used in the study were ranibizumab (51.5%), bevacizumab (33.5%), and aflibercept (15.0%). Seven eyes (5.6%) developed PVD after intravitreal drug injection (3 eyes after the first intravitreal injection: bevacizumab in 1 and ranibizumab in 2; 2 eyes after the second injection: ranibizumab in 1 and bevacizumab in 1; 1 eye after the fourth injection: ranibizumab; and 1 eye after the sixth injection: aflibercept). A total of 118 eyes remained with persistent VMA. All 7 eyes that developed PVD were classified as having focal VMA, with the diameter of vitreous attachment ranging from 210 to 1146 μm (mean, 600 μm).

CONCLUSIONS

Intravitreal injections of commonly used anti-VEGF intravitreal drugs rarely induce PVD in patients with neovascular AMD. Eyes with focal VMA have a greater chance to develop PVD than eyes with a broad area of VMA.

Authors+Show Affiliations

Retina Section, Department of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: cerveloso@hotmail.com.Retina Section, Department of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.Retina Section, Department of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.Retina Section, Department of Ophthalmology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26038338

Citation

Veloso, Carlos E., et al. "Vitreomacular Interface After Anti-Vascular Endothelial Growth Factor Injections in Neovascular Age-Related Macular Degeneration." Ophthalmology, vol. 122, no. 8, 2015, pp. 1569-72.
Veloso CE, Kanadani TM, Pereira FB, et al. Vitreomacular Interface after Anti-Vascular Endothelial Growth Factor Injections in Neovascular Age-Related Macular Degeneration. Ophthalmology. 2015;122(8):1569-72.
Veloso, C. E., Kanadani, T. M., Pereira, F. B., & Nehemy, M. B. (2015). Vitreomacular Interface after Anti-Vascular Endothelial Growth Factor Injections in Neovascular Age-Related Macular Degeneration. Ophthalmology, 122(8), pp. 1569-72. doi:10.1016/j.ophtha.2015.04.028.
Veloso CE, et al. Vitreomacular Interface After Anti-Vascular Endothelial Growth Factor Injections in Neovascular Age-Related Macular Degeneration. Ophthalmology. 2015;122(8):1569-72. PubMed PMID: 26038338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitreomacular Interface after Anti-Vascular Endothelial Growth Factor Injections in Neovascular Age-Related Macular Degeneration. AU - Veloso,Carlos E, AU - Kanadani,Tereza M, AU - Pereira,Frederico B, AU - Nehemy,Márcio B, Y1 - 2015/05/30/ PY - 2015/02/27/received PY - 2015/04/22/revised PY - 2015/04/22/accepted PY - 2015/6/4/entrez PY - 2015/6/4/pubmed PY - 2015/10/17/medline SP - 1569 EP - 72 JF - Ophthalmology JO - Ophthalmology VL - 122 IS - 8 N2 - PURPOSE: To evaluate the incidence of posterior vitreous detachment (PVD) induced by intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents in cases of neovascular age-related macular degeneration (AMD). DESIGN: Cohort study conducted at a single tertiary referral vitreoretinal practice. PARTICIPANTS: A total of 396 eyes of 295 patients were diagnosed with neovascular AMD between 2009 and 2014. A total of 125 eyes of 112 patients met the inclusion criteria and were evaluated in this study. METHODS: This study included patients with neovascular AMD who presented vitreomacular adhesion (VMA) detected by spectral-domain optical coherence tomography (OCT) at baseline. Eyes with VMA were classified according to the diameter of vitreous attachment to the macular surface measured by OCT, with attachment of ≤1500 μm defined as focal and attachment of >1500 μm defined as broad. All patients received at least 3 monthly intravitreal injections of anti-VEGF agents. Follow-up visits were performed 1 month after each intravitreal injection and included OCT analysis to evaluate the incidence of PVD. MAIN OUTCOME MEASURES: Posterior vitreous detachment induced by anti-VEGF injections. RESULTS: The mean follow-up period was 21.3 months (range, 3-59 months). The mean number of intravitreal injections was 8.3 (range, 3-29 injections). Intravitreal drugs used in the study were ranibizumab (51.5%), bevacizumab (33.5%), and aflibercept (15.0%). Seven eyes (5.6%) developed PVD after intravitreal drug injection (3 eyes after the first intravitreal injection: bevacizumab in 1 and ranibizumab in 2; 2 eyes after the second injection: ranibizumab in 1 and bevacizumab in 1; 1 eye after the fourth injection: ranibizumab; and 1 eye after the sixth injection: aflibercept). A total of 118 eyes remained with persistent VMA. All 7 eyes that developed PVD were classified as having focal VMA, with the diameter of vitreous attachment ranging from 210 to 1146 μm (mean, 600 μm). CONCLUSIONS: Intravitreal injections of commonly used anti-VEGF intravitreal drugs rarely induce PVD in patients with neovascular AMD. Eyes with focal VMA have a greater chance to develop PVD than eyes with a broad area of VMA. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/26038338/Vitreomacular_Interface_after_Anti_Vascular_Endothelial_Growth_Factor_Injections_in_Neovascular_Age_Related_Macular_Degeneration_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(15)00410-8 DB - PRIME DP - Unbound Medicine ER -