The Incidence and Causes of Abrupt Visual Loss by Jae Hui Kim, Young Suk Chang, Jong Woo Kim, ChulGu Kim, Dong Won Lee, South Korea



To investigate the incidence and causes of abrupt visual loss during anti-vascular endothelial growth factor (VEGF) treatment for type 3 neovascularization.


This retrospective study included 137 eyes that were newly diagnosed with type 3 neovascularization. All eyes were treated with anti-VEGF therapy. Abrupt visual loss was defined as patients losing 5 or more lines in best-corrected visual acuity (BCVA)in comparison to the previous visit. The incidence, timing, and cause of abrupt visual loss were identified. In addition, the BCVA at the final follow-up were compared between the eyes with and without abrupt visual loss.


The mean follow-up period was 42.4± 18.9 months after diagnosis, and abrupt visual loss was noted in 22 eyes (16.1%) at a mean of 19.6 ±13.9 months. The cause of the visual loss was subretinal hemorrhage in 11 eyes (50.0%), development of or increase in the height of pigment epithelial detachment with fluid in 8 eyes (36.4%), and tears of the retinal pigment epithelium in 3 eyes (13.6%). The mean BCVA at final follow-up was 2.07 ± 0.67 (Snellen equivalents: 20/2349) and 1.00 ±0.55 (20/200) in eyes with and without abrupt visual loss, respectively. The BCVA was significantly worse in the eyes with abrupt visual loss (P < 0.001).


Abrupt visual loss was noted in 16.1% of patients with type 3 neovascularization and was associated with poor visual outcome.Additional studies are needed on methods for preventing the development of these events.


Jae Hui Kim, Young Suk Chang, Jong Woo Kim, ChulGu Kim, Dong Won Lee
Kim’s Eye Hospital
South Korea
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