CNV vascularised PED = fibrovascular PED and serous PED with neovascularisation (occult )
In this type of CNV there is a PED (pigment epithelial detachment)
a PED..pigment epithelial detachment, with CNV (choroidal neovascularisation): with a PED. This condition usually progresses, but progression rates are very variable.
In this type of wet ARMD the damaged area looks like a dome, but in addition fluid leaks under the retina, hence the term 'wet'.
Anti-VEGF drugs generally help. The PED may reduce in size with treatment, and treatment will reduce intraretinal and subretinal fluid. Retina 2011. Occasionally the retina may 'rip', causing more loss of sight Eye 2011. Overall, 15% of PEDs rip, but the risk is proportional to the PED size, so a large PED is much more likely to rip. About of 8% of patients may develop worse sight with treatment Retina 17. The rip typically occurs 2 months after starting treatment. The rip may not cause that much visual loss initially, but central vision may get worse over time.
November, 7 months later, a PED has developed, with a retinal haemorrhage. Also, intraretinal and subretinal fluid.
Patient, age 86, April, reasonable vision 6/24 Photo / OCT show drusen, hard and soft enlarge
A wrinkled PED
This probably represents CNV without subretnal fluid, and needs treatment Retina18:
- OCT changes Retina 20
- treatment should focus on vision gains rather that PED resolution Retina 18. We dont need to elimniate the PED to get the best results.
- ARMD with a PED is classified as CNV, type 1. Outcomes Eye 11
- Look for polyps, see PCV.
- photo case 9 r/l left case.
- There are 3 types of PED, reviewed here (avascular, occult, polypoidal).
- photo avascular PED
- intraretinal cysts indicate a poorer response BJO14; combined with geographic atrophy BJO 14
- treatment helps stabilize/improve SIO 15; fluid fluctuates with injections every 2 months; serous PEDs respond better Retina 16; incomplete response to anti-vegf AJO 16 Variable response Retina 17. Good response Retina 18
- Genetics Retina 20
The PED changes with treatment but may not disappear