Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics · 2010
Macular hole formation in the presence of a pigment epithelial detachment after three consecutive intravitreal antivascular endothelial growth factor injections.
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Clemens Christoph R, Holz Frank G, Meyer Carsten H
Аннотация
PURPOSE: The aim of this study was to demonstrate the development of a macular hole (MH) and vitreomacular attachment (VMA) after treatment of a subfoveal pigment epithelial detachment (PED) by 3 consecutive antivascular endothelial growth factor (VEGF) injections in a patient with age-related macular degeneration (AMD).
METHODS: A 67-year-old woman with a subfoveal PED and occult choroidal neovascularization received 3 consecutive intravitreal ranibizumab injections in her left eye. Her initial visual acuity (VA) was 20/30.
RESULTS: Her VA stabilized at 20/30 at 3 months after the last injection; however, cross-sectional scans using optical coherence tomography (OCT) demonstrated a small vitreous attachment on the retinal surface at the foveola. Two months later, her VA was decreased to 20/100, and on biomicroscopy there was a positive Watzke sign on the center of the PED. OCT disclosed an increased VMA with a full-thickness MH. The perpendicular retina was elevated, whereas the PED appeared stabile.
CONCLUSION: Consecutive intravitreal injections may alter the vitreous gel, thus inducing a posterior vitreous detachment or VMA. New symptoms after the uploading phase with decreased VA or metamorphopsia may not necessarily relate to a progression of the AMD, but may also relate to a novel incomplete posterior vitreous vitreomacular traction possibly triggering the formation of traction and MH formation.
METHODS: A 67-year-old woman with a subfoveal PED and occult choroidal neovascularization received 3 consecutive intravitreal ranibizumab injections in her left eye. Her initial visual acuity (VA) was 20/30.
RESULTS: Her VA stabilized at 20/30 at 3 months after the last injection; however, cross-sectional scans using optical coherence tomography (OCT) demonstrated a small vitreous attachment on the retinal surface at the foveola. Two months later, her VA was decreased to 20/100, and on biomicroscopy there was a positive Watzke sign on the center of the PED. OCT disclosed an increased VMA with a full-thickness MH. The perpendicular retina was elevated, whereas the PED appeared stabile.
CONCLUSION: Consecutive intravitreal injections may alter the vitreous gel, thus inducing a posterior vitreous detachment or VMA. New symptoms after the uploading phase with decreased VA or metamorphopsia may not necessarily relate to a progression of the AMD, but may also relate to a novel incomplete posterior vitreous vitreomacular traction possibly triggering the formation of traction and MH formation.