Javaheri M, Hill L, Ghanekar A, et al. - In this post hoc analysis of a randomized clinical trial, researchers sought to describe changes in treatment-naive pigment epithelial detachments (PEDs) associated with the initial anti-vascular endothelial growth factor (VEGF) injection. For this analysis, 1,089 eligible treatment-naive patients with subfoveal neovascular age-related macular degeneration (nAMD) were randomized to ranibizumab, 0.5 mg or 2.0 mg, intravitreal injections, administered monthly or as needed (PRN), following 3 monthly loading doses. Two hundred eight patients (35.5%) with PEDs at baseline had a flattened PED after the first anti-VEGF injection. After the initial ranibizumab injection nearly one-third and after the second injection about one-half had flattened PEDS in this group of treatment-naive patients with PED from nAMD, although visual outcomes were not superior among those that did vs did not have flattening. The results indicate that flattening can serve as a marker for less intensive as-needed injection frequencies.