Effect of anti-VEGF treatment on PED morphology
Reviewed by Jayavani Myneni

This retrospective study of 30 eyes assessed the effect of anti-VEGF on morphology of pigment epithelial detachments (PED) secondary to age-related macular degeneration (AMD). Thirty eyes of 28 patients with PED were compared to 30 eyes of 30 patients with AMD without PED component. The subjects in both groups were individually matched for gender, BCVA before treatment with anti-VEGF, follow-up period and age. All patients received ranibizumab monthly for the first three months followed by PRN treatment. Mean follow-up period was 19.8 months. Morphological changes of PED on OCT were qualitatively assessed by three masked investigators. OCT scans of the same orientation were chosen for comparison only if there was agreement among the three investigators. These changes were correlated with improvements in BCVA. Number of injections and BCVA were compared among the two groups. Extent of PED when compared to baseline were graded as unchanged in 36.7%, reduced in 40% and significantly reduced in 23.3% of eyes. No eyes showed an increase in size. No evidence was found that improvements in PED correlate to improvements in BCVA. No RPE tear was observed in this study. The limitations of the study are small size of study groups, retrospective comparison, lack of quantitative analysis of PED volume and grouping of all types of PED without classification. This study provides supporting evidence that anti-VEGF therapy stabilises or improves PED extent in wet AMD. 

The effect of intravitreal anti-VEGF on the pigment epithelial detachment in eyes with the exudative type of age-related macular degeneration.
Kalouda P, Anastasakis A, Tsika C, Tsilimbaris KM.
SEMINARS IN OPHTHALMOLOGY
2015;30(1):6-10.