Effects of Vegf Inhibition on Retinal Morphology, Neovascular Network Size, and Visual Acuity in Patients With Vascularized Pigment Epithelium Detachment Because of Occult Choroidal Neovascularization

In Brief Purpose: To report the results of vascular endothelial growth factor inhibition for vascularized pigment epithelium detachment associated with choroidal neovascularization secondary to age-related macular degeneration. Methods: We performed a retrospective analysis of patients affected by vascularized pigment epithelium detachment treated with intravitreal anti–vascular endothelial growth factor (0.5 mg of ranibizumab or 1 mg of bevacizumab) and a follow-up of 12 months. Retinal angiomatous proliferations were excluded. Treatment was conducted with an initial loading phase followed by a pro re nata phase. Fluorescein angiography and indocyanine green angiography were performed at baseline and every 3 months. Results: Forty eyes were included in this study. After a follow-up of 12 months and 5.5 treatments on average, best-corrected visual acuity did not vary significantly. Central retinal thickness and pigment epithelium detachment height were significantly reduced, whereas the choroidal neovascularization area remained constant. Conclusion: In vascularized pigment epithelium detachment, anti–vascular endothelial growth factor therapy shows visual stabilization but not best-corrected visual acuity gain. However, it is associated with significant morphologic improvements, and it may offer a benefit over the natural course of the disease. Anti–vascular endothelial growth factor therapy for vascularized pigment epithelium detachment over a 12-month period produces a reduction of pigment epithelium detachment height, a decrease of intraretinal and subretinal fluid, and a stabilization of the choroidal neovascular network size. Best-corrected visual acuity did not change significantly during the follow-up.