High incidence of vitreomacular traction in recurrent choroidal neovascularisation after repeated photodynamic therapy.

BACKGROUND

The causes of recurrent choroidal neovascularisation (CNV) after photodynamic therapy (PDT) remain controversial. Subretinal surgery was carried out after unsuccessful PDT.

AIMS: To determine intraoperatively the status of the posterior vitreous interface.

DESIGN

Interventional case series.

METHODS

Conventional three-port vitrectomy was carried out in 10 eyes with CNV that had undergone 1-4 PDT sessions. The vitreous cutter was held close to the edge of the optic nerve to evaluate the status of the posterior vitreous.

RESULTS

Lesion size showed an increase from 1.5 (standard deviation (SD) 0.53) to 2.3 (SD 0.83) macular photocoagulation study disc diameters, between the first and the last PDT. Intraoperative findings during vitrectomy showed little liquefaction of the vitreous gel and an incomplete posterior-vitreous detachment, with remarkably firm attachments at the macula in all cases (10/10).

CONCLUSION

We determined an abnormally high incidence of vitreous attachments in eyes with recurrent CNV. Vitreomacular attachments may trigger the progression or recurrence of CNV.