Purpose: To describe the use of half-dose anti-vascular endothelial growth factor therapy in a patient with giant pigment epithelial detachments.
Methods: Observational case report. A 76-year-old woman with neovascular age-related macular degeneration presented with massive bilateral pigment epithelial detachments measuring over 1000 μm in height. Her right eye was treated with standard-dose aflibercept, which led to two large retinal pigment epithelium tears. Treatment of the left eye with half-dose aflibercept led to complete resolution of the detachment without tear formation.
Results: Half-dose anti-vascular endothelial growth factor therapy resulted in resolution of a giant pigment epithelial detachment ∼1500 μm in maximal height and 10 mm in diameter.
Conclusion: Reduced-dose anti-vascular endothelial growth factor therapy may be considered as a treatment option for very large pigment epithelial detachments at high risk for retinal pigment epithelium tear formation.