Quantitative changes in retinal pigment epithelial detachments as a predictor for retreatment with anti-VEGF therapy.

Purpose: To determine if quantitative changes in retinal pigment epithelial detachments (PEDs) predict the need for retreatment in eyes undergoing spectral domain optical coherence tomography (SD OCT)-guided as-needed therapy with anti-vascular endothelial growth factor drugs.

Methods: Patients with vascularized PEDs undergoing SD OCT-guided treatment with anti-vascular endothelial growth factor drugs were retrospectively identified. The decision to retreat these cases was based on qualitative assessments of fluid in the macula. Spectral domain OCT images from visits in which the treatment was withheld were retrospectively analyzed. A novel algorithm was then used to measure the area and volume of PEDs at these visits.

Results: Fourteen eyes were identified, and retreatment was withheld at 57 visits. When the SD OCT algorithm was used to evaluate the scans from these visits, the PED volume increased at eight visits. At all of these eight visits, a treatment was needed at the next follow-up visit. For the remaining 49 visits in which the treatment was withheld, the PED volume did not increase and no treatment was needed at the next follow-up visit.

Conclusion: Quantitation of the change in the PED volume and area may be useful in determining when to retreat eyes undergoing SD OCT-guided as-needed anti-vascular endothelial growth factor therapy.