Purpose:

To evaluate the prevalence of retinal pigment epithelium (RPE) tears associated with anti-VEGF therapy and its relation with neovascular retinal pigment epithelial detachment (PED).

Methods:

A total of 226 patients with exudative age-related macular degeneration treated with intravitreal anti-VEGF were included retrospectively in the study. The presence of RPE tears; the effect of the presence, height, and duration of PED on the rate of RPE tears; and change in visual acuity during follow-up were recorded.

Results:

Among 226 study patients, 28 (12.3%) had RPE tears. The RPE tear rate was significantly higher in patients with PED than in those without PED (19.7% vs. 2.1%; p<0.001). The change in visual acuity with an RPE tear was not significant (on logMAR scale: 0.92±0.49 initially, 0.89±0.41 after the RPE tear, 0.96±0.45 at the last follow-up; p=0.613). PED height >580 µm (OR=69.4; 95%CI=16.7–288.1) and PED duration ≤4.5 months (OR=166.7; 95%CI=15.2–1000) were significant risk factors for RPE tear formation.

Conclusion:

The RPE tears are not seldom among eyes treated with intravitreal anti-VEGFs. The presence of PED, high PED height, and short duration of PED are potential risk factors for RPE tears associated with anti-VEGF therapy.