Author: Maria Vittoria Cicinelli
Co-authors: Alessandro Rabiolo, Giovanni Montesano, Alessandro Marchese, Ugo Introini, Francesco Bandello
Abstract
Purpose: To investigate demographic and clinical factors influencing the longitudinal changes of retinal pigment epithelium (RPE) dehiscence area after RPE tears, including the presence of RPE tear-associated repair proliferation (TARP), and to identify factors associated with TARP development over follow-up.Setting: Retrospective, single-center, observational cohort study seen at San Raffaele Scientific Institute (Milano)
Methods: Patients with a history of macular neovascularization and RPE tear were recruited. The area of RPE dehiscence was measured on repeated short-wavelength fundus autofluorescence imaging. The associations between potential covariates and RPE dehiscence areas were tested with multivariable linear mixed models. Associations between TARP development and clinical variables were investigated with Cox proportional hazard regression models. Visual acuity was regressed against time with linear mixed models.
Results: Thirty-seven eyes of 36 patients were included in this study and followed for a median time of 18 months. TARP was identified in 27 eyes (73%). The median time for TARP detection was 112 days; none of the investigated factors was significantly associated with TARP occurrence. The presence of TARP ( estimate: -0.042 mm2/month, p=0.001) and female gender ( estimate: -0.035 mm2/month, p=0.006) were associated with slower rates of RPE dehiscence enlargement over time. Faster rate of visual improvement was seen in eyes with TARP compared with those without TARP (β = -0.012 LogMAR/month if TARP was present, p
Conclusions: RPE tear repair with TARP and female gender slow down further RPE degeneration after RPE tears. TARP was associated better visual prognosis. Additional research on factors promoting TARP development may have therapeutic and prognostic implications.
