Atsushi Fujiwara
   Department   Kawasaki University of Medical Welfare  ,
   Position   Assistant Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Efficacy of vitrectomy and inner limiting membrane peeling in age-related macular degeneration resistant to anti-vascular endothelial growth factor therapy, with vitreomacular traction or epiretinal membrane.
Journal Formal name：Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
Abbreviation：Graefes Arch Clin Exp Ophthalmol
ISSN code：1435702X/0721832X
Domestic / ForeginForegin
Volume, Issue, Page 254(9),pp.1731-1736
Author and coauthor Kimura Shuhei, Morizane Yuki, Toshima Shinji, Hosogi Mika, Kumase Fumiaki, Hosokawa Mio, Shiode Yusuke, Fujiwara Atsushi, Shiraga Fumio
Publication date 2016/09
Summary PURPOSE:We assessed the efficacy of vitrectomy and inner limiting membrane (ILM) peeling, followed by anti-vascular endothelial growth factor (VEGF) therapy, anti-VEGF-resistant age-related macular degeneration (AMD) due to vitreomacular traction (VMT) or epiretinal membrane (ERM).METHODS:We identified six patients with anti-VEGF-resistant AMD due to VMT or ERM amongst a total of 588 patients with AMD (821 eyes) referred to Okayama University Hospital between February 2012 and May 2014. These patients underwent vitrectomy to release the VMT (4 cases) or remove the ERM (2 cases), along with ILM peeling. The regimen used for intravitreal injections of anti-VEGF reagents after surgery was based on the severity of exudative changes in each patient. Preoperative and postoperative best-corrected visual acuity (BCVA) and central retinal thickness (CRT) measurements were compared.RESULTS:After vitrectomy and ILM peeling, all six patients responded to anti-VEGF therapy, which was then able to maintain dry retinas. Mean BCVA did not improve significantly (0.49 ± 0.28 before vs. 0.43 ± 0.38 after surgery, P = 0.538). However, mean CR was significantly decreased after surgery, from 423 ± 83.5 μm to 257 ± 75.8 μm (P = 0.0078).CONCLUSIONS:Vitrectomy and ILM peeling followed by anti-VEGF therapy may be a useful therapeutic option for anti-VEGF-resistant AMD with VMT or ERM.
DOI 10.1007/s00417-016-3314-1
PMID 26951250