Additional Anti–vascular Endothelial Growth Factor Therapy for Eyes With a Retinal Pigment Epithelial Tear After the Initial Therapy

In Brief Purpose: To evaluate the effects of additional anti–vascular endothelial growth factor (VEGF) therapy for eyes with a retinal pigment epithelial (RPE) tear after anti-VEGF therapy and treated with additional anti-VEGF injections for recurrent or persistent exudative change. Patients and Methods: Ten eyes (10 patients) followed up for >12 months after a recurrent RPE tear were evaluated retrospectively. The RPE tears on fundus autofluorescence images were measured and changes in the best-corrected visual acuity were evaluated. Results: Patients were followed up for >12 months (mean, 27.3; range, 13–44 months). During 12 months of follow-up, additional anti-VEGF injections (mean, 3.3; range, 1–7) were administered. The mean size of the RPE tear at the onset was 6.5 mm2 (range, 1.3–16.3 mm2). At 12 months, the RPE tear increased in size >20% in 5 eyes and remained unchanged or decreased in the remaining half of eyes. The mean logarithm of the minimum angle of resolution best-corrected visual acuity was 0.43 at the time the RPE tear developed and 0.85 at 12 months. The RPE tear grade and age were prognostic factors for best-corrected visual acuity at 12 months. Conclusion: Under continued anti-VEGF therapy, RPE tears may be stable in size and visual acuity could be maintained in some eyes; however, the visual acuity prognosis is still unsatisfactory in nonresponsive eyes. Retinal pigment epithelial tears after anti–vascular endothelial growth factor therapy may be stable in size, and visual acuity could be maintained with continuous anti–vascular endothelial growth factor treatment, although the visual acuity prognosis is still unsatisfactory in nonresponsive eyes.