{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:31:28Z","timestamp":1767713488498,"version":"3.37.3"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background The goals of this study are to evaluate potential long-term visual deterioration associated with retinal pigment epithelial (RPE) tears in patients with neovascular age-related macular degeneration (nAMD) and to find treatment-related and morphological factors that might influence the outcomes.<\/jats:p><jats:p>\n          Patients and Methods This retrospective study enrolled 21 eyes of 21 patients from the database of Vista Eye Clinic Binningen, Switzerland, diagnosed with RPE tears, as confirmed by spectral domain optical coherence tomography (SD-OCT), with a minimum follow-up period of 12 months. Treatment history before and after RPE rupture with anti-VEGF therapy, visual acuity, and imaging (SD-OCT) were analyzed and statistically evaluated for possible correlations.<\/jats:p><jats:p>\n          Results Mean patient age was 80.5\u2009\u00b1\u20096.2 years. The mean length of total follow-up was 39.7\u2009\u00b1\u200913.9 months. The mean pigment epithelial detachment (PED) height increased by 363.8\u2009\u00b1\u2009355.5\u2009\u00b5m from the first consultation to 562.8\u2009\u00b1\u2009251.5\u2009\u00b5m at the last consultation prior to rupture. Therefore, a higher risk of RPE rupture is implied as a result of an increase in PED height (p\u2009=\u20090.004, n\u2009=\u200914). The mean visual acuity before rupture was 66.2\u2009\u00b1\u200916.0 letters. Mean visual acuity deteriorated to 60.8\u2009\u00b1\u200918.6 letters at the first consultation after rupture (p\u2009=\u20090.052, n\u2009=\u200921). A statistically nonsignificant decrease in vision was noted in the follow-up period. After 2 years, the mean BCVA decreased by 10.5\u2009\u00b1\u200923.7 ETDRS letters (p\u2009=\u20090.23, n\u2009=\u200919). PED characteristics before rupture and amount of anti-VEGF injections after rupture did not affect the visual outcome. None of the 21 patients included in our study showed a visual improvement in the long-term follow-up. RPE atrophy\n          increased significantly from 3.35\u2009\u00b1\u20092.94\u2009mm2 (baseline) to 6.81\u2009\u00b1\u20096.25\u2009mm2 over the course of 2 years (p\u2009=\u20090.000\u200a013, n\u2009=\u200920).<\/jats:p><jats:p>\n          Conclusions The overall mean vision decrease after rupture was without statistical significance. There was no significant change in BCVA at the 2-year follow-up, independent of the amount of anti-VEGF injections provided. In this study, there was a significant increase in RPE defect over a follow-up of 2 years, implying progression of contraction of RPE and\/or macular atrophy.<\/jats:p>","DOI":"10.1055\/a-2248-9986","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:15:51Z","timestamp":1710461751000},"page":"453-458","source":"Crossref","is-referenced-by-count":1,"title":["Long-term Follow-Up and Regeneration of Retinal Pigment Epithelium (RPE) after Tears of the Epithelium in Exudative Age-Related Macular Degeneration (AMD)"],"prefix":"10.1055","volume":"241","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9476-2628","authenticated-orcid":false,"given":"Nicolas","family":"Skalicky","sequence":"additional","affiliation":[{"name":"Vista Eye Clinic, Binningen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katja","family":"Hatz-Wurziger","sequence":"additional","affiliation":[{"name":"Vista Eye Clinic, Binningen, Switzerland"},{"name":"University of Basel, Faculty of Medicine, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1016\/S2214-109X(20)30489-7","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study","volume":"9","author":"GBD 2019 Blindness and Vision Impairment Collaborators","year":"2021","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.survophthal.2007.02.008","article-title":"Retinal pigment epithelial detachment","volume":"52","author":"S Zayit-Soudry","year":"2007","journal-title":"Surv Ophthalmol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.survophthal.2017.03.004","article-title":"Retinal pigment epithelium tears: classification, pathogenesis, predictors, and management","volume":"62","author":"M G Ersoz","year":"2017","journal-title":"Surv Ophthalmol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0161-6420(83)34534-6","article-title":"Retinal pigment epithelial tears","volume":"90","author":"W L Decker","year":"1983","journal-title":"Ophthalmology"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1016\/j.ophtha.2011.05.026","article-title":"Incidence of retinal pigment epithelial tears after intravitreal ranibizumab injection for neovascular age-related macular degeneration","volume":"118","author":"E T Cunningham jr.","year":"2011","journal-title":"Ophthalmology"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1136\/bjo.69.6.397","article-title":"Retinal pigment epithelial detachments in the elderly: classification and outcome","volume":"69","author":"A G Casswell","year":"1985","journal-title":"Br J Ophthalmol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1136\/bjo.65.6.417","article-title":"Tears of detached retinal pigment epithelium","volume":"65","author":"A Hoskin","year":"1981","journal-title":"Br J Ophthalmol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1097\/IAE.0b013e3180342c42","article-title":"RPE tears after pegaptanib treatment in age-related macular degeneration","volume":"27","author":"L K Chang","year":"2007","journal-title":"Retina"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1016\/j.ophtha.2016.07.007","article-title":"Ranibizumab treatment for pigment epithelial detachment secondary to neovascular age-related macular degeneration: post hoc analysis of the HARBOR study","volume":"123","author":"D Sarraf","year":"2016","journal-title":"Ophthalmology"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1097\/IAE.0b013e31817d5d03","article-title":"Predictors of anti-VEGF-associated retinal pigment epithelial tear using FA and OCT analysis","volume":"28","author":"A Chiang","year":"2008","journal-title":"Retina"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.ajo.2013.06.024","article-title":"Mechanism of retinal pigment epithelium tear formation following intravitreal anti\u2013vascular endothelial growth factor therapy revealed by spectral-domain optical coherence tomography","volume":"156","author":"A Nagiel","year":"2013","journal-title":"Am J Ophthalmol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1055\/s-2007-962949","article-title":"Intravitreal triamcinolone acetonide for serous retinal pigment epithelial detachments in exudative age-related macular degeneration","volume":"224","author":"F K Sutter","year":"2007","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1007\/s00417-012-1955-2","article-title":"Vascularized retinal pigment epithelial detachment in age-related macular degeneration: treatment and RPE tear incidence","volume":"250","author":"U Introini","year":"2012","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.ajo.2008.10.005","article-title":"Enhanced depth imaging optical coherence tomography of retinal pigment epithelial detachment in age-related macular degeneration","volume":"147","author":"R F Spaide","year":"2009","journal-title":"Am J Ophthalmol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"570","DOI":"10.3928\/15428877-20091030-06","article-title":"Optical coherence tomography predictors of retinal pigment epithelial tear following intravitreal bevacizumab injection","volume":"40","author":"I Moroz","year":"2009","journal-title":"Ophthalmic Surg Lasers Imaging"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1001\/archopht.1990.01070140041025","article-title":"The pretear characteristics of pigment epithelial detachments. A study of 40 eyes","volume":"108","author":"G Coscas","year":"1990","journal-title":"Arch Ophthalmol"},{"key":"ref17","first-page":"270","article-title":"[Predictive near-infrared SLO signs for tears of the retinal pigment epithelium due to age-related macular degeneration]","volume":"230","author":"N Bastian","year":"2013","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref18","first-page":"142","article-title":"Retinal pigment epithelial tears in the era of intravitreal pharmacotherapy: risk factors, pathogenesis, prognosis and treatment (an American Ophthalmological Society thesis)","volume":"112","author":"D Sarraf","year":"2014","journal-title":"Trans Am Ophthalmol Soc"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1097\/IAE.0b013e3181d87e04","article-title":"Novel method for analyzing Snellen visual acuity measurements","volume":"30","author":"N Z Gregori","year":"2010","journal-title":"Retina"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1159\/000530418","article-title":"Geographic Atrophy in AMD: Prognostic Factors Based on Long-Term Follow-Up","volume":"66","author":"L Cedro","year":"2023","journal-title":"Ophthalmic Res"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"326","DOI":"10.3928\/23258160-20170329-07","article-title":"Pre-existing RPE atrophy and defects in the external limiting membrane predict early poor visual response to ranibizumab in neovascular age-related macular degeneration","volume":"48","author":"S Zandi","year":"2017","journal-title":"Ophthalmic Surg Lasers Imaging Retina"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"706084","DOI":"10.3389\/fmed.2021.706084","article-title":"External Limiting Membrane Disruption Predicts Long-Term Outcome in Strict Treat-And-Extend Regimen in Neovascular Age-Related Macular Degeneration","volume":"8","author":"L Hoffmann","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"622877","DOI":"10.3389\/fmed.2020.622877","article-title":"Strongest correlation between contrast sensitivity and morphological characteristics in bilateral nAMD","volume":"7","author":"L Hoffmann","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1097\/IAE.0000000000000823","article-title":"Retinal pigment epithelial tear and anti-vascular endothelial growth factor therapy in exudative age-related macular degeneration: clinical course and long-term prognosis","volume":"36","author":"B Heimes","year":"2016","journal-title":"Retina"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"5962","DOI":"10.1038\/s41598-021-85270-x","article-title":"Optical coherence tomography features of the repair tissue following RPE tear and their correlation with visual outcomes","volume":"11","author":"F Romano","year":"2021","journal-title":"Sci Rep"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1097\/IAE.0000000000000056","article-title":"Pigment epithelial tears associated with anti-VEGF therapy: incidence, long-term visual outcome, and relationship with pigment epithelial detachment in age-related macular degeneration","volume":"34","author":"S Doguizi","year":"2014","journal-title":"Retina"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1038\/eye.2008.145","article-title":"Can the risk of retinal pigment epithelium tears after bevacizumab treatment be predicted? An optical coherence tomography study","volume":"22","author":"M Leitritz","year":"2008","journal-title":"Eye (Lond)"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1097\/IAE.0b013e31828992f5","article-title":"Prospective evaluation of the incidence and risk factors for the development of RPE tears after high-and low-dose ranibizumab therapy","volume":"33","author":"D Sarraf","year":"2013","journal-title":"Retina"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/ICB.0000000000000184","article-title":"Resolution of a giant pigment epithelial detachment with half-dose aflibercept","volume":"9","author":"A Nagiel","year":"2015","journal-title":"Retin Cases Brief Rep"},{"key":"ref30","first-page":"1089","article-title":"Bimonthly half-dose ranibizumab in large pigment epithelial detachment and retinal angiomatous proliferation with high risk of retinal pigment epithelium tear: a case report","volume":"7","author":"J Mon\u00e9s","year":"2013","journal-title":"Clin Ophthalmol"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1097\/IAE.0000000000003083","article-title":"Management of retinal pigment epithelium tear during anti\u2013vascular endothelial growth factor therapy","volume":"41","author":"P Mitchell","year":"2021","journal-title":"Retina"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr Augenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2248-9986.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T16:28:35Z","timestamp":1730824115000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2248-9986"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,14]]},"references-count":31,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2024,4,23]]},"published-print":{"date-parts":[[2024,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2248-9986","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0023-2165","1439-3999"],"issn-type":[{"type":"print","value":"0023-2165"},{"type":"electronic","value":"1439-3999"}],"subject":[],"published":{"date-parts":[[2024,3,14]]}}}