PT  - JOURNAL ARTICLE
AU  - Omar S Punjabi
AU  - Joyce Huang
AU  - Lina Rodriguez
AU  - Alice T Lyon
AU  - Lee M Jampol
AU  - Rukhsana G Mirza
TI  - Imaging characteristics of neovascular pigment epithelial detachments and their response to anti-vascular endothelial growth factor therapy
AID  - 10.1136/bjophthalmol-2013-303155
DP  - 2013 Aug 01
TA  - British Journal of Ophthalmology
PG  - 1024--1031
VI  - 97
IP  - 8
4099  - http://bjo.bmj.com/content/97/8/1024.short
4100  - http://bjo.bmj.com/content/97/8/1024.full
SO  - Br J Ophthalmol2013 Aug 01; 97
AB  - Purpose To evaluate the imaging characteristics of macular neovascular pigment epithelial detachments (PEDs) and their response to anti-vascular endothelial growth factor (VEGF) therapy. Methods Patients with exudative age-related macular degeneration (AMD), idiopathic polypoidal choroidal vasculopathy, presumed ocular histoplasmosis syndrome (POHS) and central serous retinopathy (CSR) with choroidal neovascularisation (CNV) were included in the study. A retrospective chart review of 72 eyes of 64 patients was performed. Results Three types of PEDs were identified based on reflectivity of the material under the retinal pigment epithelium on optical coherence tomography: hollow (26 eyes with primarily hyporeflectivity under the PED), solid (30 eyes with primarily hyperreflective signal under the PED) and mixed (8 eyes with mixed reflectivity). The average number of anti-VEGF injections was 7 per eye and the average duration of follow-up was 16 months. Among eyes with exudative AMD, 7/21 hollow PEDs flattened, 1/19 solid PEDs flattened and 2/6 mixed PEDs flattened after anti-VEGF therapy. POHS and CSR with CNV were associated with subfoveal solid PEDs and were unchanged after therapy. Overall, 46% (12/26) with hollow PEDs, 25% (2/8) with mixed PEDs and 3% (1/30) with solid PEDs had flattening after anti-VEGF therapy. Conclusions The likelihood of PED flattening was inversely related to the reflectivity of the PED. The more reflective the PED, the less likely resolution with anti-VEGF therapy occurred.