Jules Gonin University Eye Hospital, Lausanne, Switzerland.
Acta Ophthalmol. 2010 Nov;88(7):736-41. doi: 10.1111/j.1755-3768.2009.01547.x.
Retinal pigment epithelium (RPE) tear is an extremely rare complication in patients with classic neovascular membranes without RPE detachment. We evaluate their incidence and functional outcome following treatment with intravitreal ranibizumab.
Observational study of 72 consecutive patients (74 eyes) treated at Jules Gonin University Eye Hospital, Lausanne, with intravitreal ranibizumab 0.5 mg for classic choroidal neovascularization (CNV) between March 2006 and February 2008. Best-corrected visual acuity (BCVA), fundus examination and optical coherence tomography were recorded monthly; fluorescein angiography was performed at baseline and repeated at least every 3 months.
RPE tears occurred in four (5.4%) eyes temporal to the fovea, after a mean of four injections (range 3-6). Mean baseline BCVA was 0.25 decimal equivalent (logMAR 0.67) and improved despite the RPE tear to 0.6 decimal equivalent (logMAR 0.22).
RPE tears following intravitreal ranibizumab injections for classic CNV can occur in about 5% of patients, even in the absence of baseline RPE detachment. Nevertheless, vision may improve provided the fovea is not involved.
在没有 RPE 脱离的经典新生血管膜患者中，RPE 撕裂是一种极其罕见的并发症。我们评估了玻璃体内注射雷珠单抗治疗后其发生率和功能结果。
对 2006 年 3 月至 2008 年 2 月在洛桑 Jules Gonin 大学眼科医院接受玻璃体内雷珠单抗 0.5mg 治疗的 72 例（74 只眼）连续患者进行观察性研究。每月记录最佳矫正视力（BCVA）、眼底检查和光学相干断层扫描；在基线时进行荧光素血管造影，并至少每 3 个月重复一次。
RPE 撕裂发生在 4 只（5.4%）眼的颞侧，平均注射 4 次（范围 3-6 次）。平均基线 BCVA 为 0.25 十进制等效值（logMAR 0.67），尽管发生了 RPE 撕裂，但仍提高至 0.6 十进制等效值（logMAR 0.22）。
即使在没有基线 RPE 脱离的情况下，玻璃体内注射雷珠单抗治疗经典 CNV 后，RPE 撕裂也可能发生在约 5%的患者中。然而，如果不涉及黄斑，视力可能会提高。
