Increasing volume of a retinal pigmented epithelial detachment as a predictor of submacular hemorrhage during anti-VEGF therapy

Vascularized retinal pigment epithelium detachments (PEDs) are part of the spectrum of neovascular age-related macular degeneration (AMD). These patients with vascularized PEDs are at a higher risk of experiencing severe vision loss. This case report demonstrates the use of a new spectral-domain optical coherence tomography (SD-OCT) algorithm to measure the area and volume of PEDs. When this algorithm was applied to the scans from a patient with a vascularized PED who developed a large submacular hemorrhage while undergoing ranibizumab therapy, the authors found that the algorithm measured an increase in the area and volume of the PED that preceded the macular hemorrhage. Although further studies are needed, the increase in the volume of a PED may serve as a useful predictor of disease progression and the need for more aggressive anti-VEGF therapy.