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PMID- 26038338
DA  - 20150727
DCOM- 20151016
LR  - 20160621
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 122
IP  - 8
DP  - 2015 Aug
TI  - Vitreomacular Interface after Anti-Vascular Endothelial Growth Factor Injections 
      in Neovascular Age-Related Macular Degeneration.
PG  - 1569-72
LID - 10.1016/j.ophtha.2015.04.028 [doi]
LID - S0161-6420(15)00410-8 [pii]
AB  - PURPOSE: To evaluate the incidence of posterior vitreous detachment (PVD) induced
      by intravitreal injections of anti-vascular endothelial growth factor (VEGF)
      agents in cases of neovascular age-related macular degeneration (AMD). DESIGN:
      Cohort study conducted at a single tertiary referral vitreoretinal practice.
      PARTICIPANTS: A total of 396 eyes of 295 patients were diagnosed with neovascular
      AMD between 2009 and 2014. A total of 125 eyes of 112 patients met the inclusion 
      criteria and were evaluated in this study. METHODS: This study included patients 
      with neovascular AMD who presented vitreomacular adhesion (VMA) detected by
      spectral-domain optical coherence tomography (OCT) at baseline. Eyes with VMA
      were classified according to the diameter of vitreous attachment to the macular
      surface measured by OCT, with attachment of </=1500 mum defined as focal and
      attachment of >1500 mum defined as broad. All patients received at least 3
      monthly intravitreal injections of anti-VEGF agents. Follow-up visits were
      performed 1 month after each intravitreal injection and included OCT analysis to 
      evaluate the incidence of PVD. MAIN OUTCOME MEASURES: Posterior vitreous
      detachment induced by anti-VEGF injections. RESULTS: The mean follow-up period
      was 21.3 months (range, 3-59 months). The mean number of intravitreal injections 
      was 8.3 (range, 3-29 injections). Intravitreal drugs used in the study were
      ranibizumab (51.5%), bevacizumab (33.5%), and aflibercept (15.0%). Seven eyes
      (5.6%) developed PVD after intravitreal drug injection (3 eyes after the first
      intravitreal injection: bevacizumab in 1 and ranibizumab in 2; 2 eyes after the
      second injection: ranibizumab in 1 and bevacizumab in 1; 1 eye after the fourth
      injection: ranibizumab; and 1 eye after the sixth injection: aflibercept). A
      total of 118 eyes remained with persistent VMA. All 7 eyes that developed PVD
      were classified as having focal VMA, with the diameter of vitreous attachment
      ranging from 210 to 1146 mum (mean, 600 mum). CONCLUSIONS: Intravitreal
      injections of commonly used anti-VEGF intravitreal drugs rarely induce PVD in
      patients with neovascular AMD. Eyes with focal VMA have a greater chance to
      develop PVD than eyes with a broad area of VMA.
CI  - Copyright (c) 2015 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Veloso, Carlos E
AU  - Veloso CE
AD  - Retina Section, Department of Ophthalmology, Federal University of Minas Gerais, 
      Belo Horizonte, MG, Brazil. Electronic address: [email protected]
FAU - Kanadani, Tereza M
AU  - Kanadani TM
AD  - Retina Section, Department of Ophthalmology, Federal University of Minas Gerais, 
      Belo Horizonte, MG, Brazil.
FAU - Pereira, Frederico B
AU  - Pereira FB
AD  - Retina Section, Department of Ophthalmology, Federal University of Minas Gerais, 
      Belo Horizonte, MG, Brazil.
FAU - Nehemy, Marcio B
AU  - Nehemy MB
AD  - Retina Section, Department of Ophthalmology, Federal University of Minas Gerais, 
      Belo Horizonte, MG, Brazil.
LA  - eng
PT  - Journal Article
DEP - 20150530
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Recombinant Fusion Proteins)
RN  - 0 (VEGFA protein, human)
RN  - 0 (Vascular Endothelial Growth Factor A)
RN  - 15C2VL427D (aflibercept)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - EC (Receptors, Vascular Endothelial Growth Factor)
RN  - ZL1R02VT79 (Ranibizumab)
SB  - IM
CIN - Ophthalmology. 2016 Mar;123(3):e21. PMID: 26902569
CIN - Ophthalmology. 2016 Mar;123(3):e21. PMID: 26902570
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiogenesis Inhibitors/*therapeutic use
MH  - Antibodies, Monoclonal, Humanized/therapeutic use
MH  - Bevacizumab
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - *Intravitreal Injections
MH  - Macula Lutea/*pathology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Ranibizumab
MH  - Receptors, Vascular Endothelial Growth Factor/therapeutic use
MH  - Recombinant Fusion Proteins/therapeutic use
MH  - Tissue Adhesions
MH  - Tomography, Optical Coherence
MH  - Vascular Endothelial Growth Factor A/antagonists & inhibitors
MH  - Vitreous Body/*pathology
MH  - Vitreous Detachment/diagnosis/*etiology
MH  - Wet Macular Degeneration/*drug therapy
EDAT- 2015/06/04 06:00
MHDA- 2015/10/17 06:00
CRDT- 2015/06/04 06:00
PHST- 2015/02/27 [received]
PHST- 2015/04/22 [revised]
PHST- 2015/04/22 [accepted]
AID - S0161-6420(15)00410-8 [pii]
AID - 10.1016/j.ophtha.2015.04.028 [doi]
PST - ppublish
SO  - Ophthalmology. 2015 Aug;122(8):1569-72. doi: 10.1016/j.ophtha.2015.04.028. Epub
      2015 May 30.

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