Lamellar Macular Hole Formation in a Patient With Diabetic CME Treated by Intravitreal Bevacizumab Injections

Erdurman, Fazıl Cüneyt; Pellumbi, Alfrida; Durukan, Ali Hakan

doi:10.3928/15428877-20120823-05

Cited by 9 publications

(5 citation statements)

References 15 publications

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“…There have been case reports of patients treated with DMO using anti-VEGF agents developing a variety of new VRIAs [26–28]. We, however, did not find any evidence for a systematic worsening in vitreoretinal traction in patients being treated for DMO.…”

Section: Discussioncontrasting

confidence: 71%

Vitreoretinal interface abnormalities in patients treatedwith ranibizumab for diabetic macular oedema

Wong

Steel

Habib

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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PurposeIntravitreal anti-vascular endothelial growth factor (VEGF) agents are effective in the treatment of central involving diabetic macular oedema (DMO). Vitreoretinal interface abnormalities (VRIA) are common in patients with DMO, and the effect of these on the response to anti-VEGF treatment is unclear. Furthermore the effect of anti-VEGF agents on the VRIA itself is uncertain.MethodProspective study of consecutive patients treated with ranibizumab (RZB) for DMO as part of routine clinical care in one eye unit over a 1-year period. Visual acuity (Va), central retinal thickness (CRT) and injection frequency data was recorded on an electronic database. Treatment was initiated with four monthly RZB injections and then a monthly PRN regime. All patients underwent high-density spectral-domain optical coherence tomography (SDOCT) at baseline and 12 months. The SDOCTs were graded by two observers masked to the outcome.ResultsOne hundred and four eyes (77 patients) were included in the analysis. The mean age was 62 years, and 62% were male. The mean presenting vision was 62 letters and CRT 472 μm. Eighty eyes retained stable Va, and 17 had an improvement in Va. At baseline, 39 eyes had associated focal vitreomacular adhesion (VMA) and by 12 months this reduced to 30 (p = 0.04), with 12 releasing VMA and three developing it. Patients with VMA had significantly better final Va than those without VMA. Improvement in CRT was greatest in those where VMA released during the study. Forty-five eyes had some degree of foveal involving epiretinal membrane (ERM) at baseline, and 28 were considered to have clinically significant ERM. There was no clinically relevant change in ERM during the study. Patients with significant ERM at baseline had a lower final vision. Multivariate analysis showed that ERM and more severe retinopathy at baseline were predictive of less visual improvement (p < 0.01). Shorter intraretinal cyst length, ERM and the absence of VMA at baseline were predictive of a worsened anatomical response (p < 0.001).ConclusionVRIA are related to outcome in patients treated with RZB. ERM was associated with a worsened visual and anatomic response, and VMA with an improved anatomical response particularly when spontaneous VMA release occurred during treatment. The presence and severity of ERM was not affected by RZB treatment.Electronic supplementary materialThe online version of this article (doi:10.1007/s00417-016-3562-0) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 71%

Vitreoretinal interface abnormalities in patients treatedwith ranibizumab for diabetic macular oedema

Wong

Steel

Habib

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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“…However, lamellar holes have been shown to form in eyes with chronic macular edema despite complete separation of posterior hyaloid and absence of epiretinal membranes. 72 The exact mechanism of hole development in such eyes is unclear.…”

Section: Macular Hole and Vitreomacular Tractionmentioning

confidence: 99%

Disease of the Year: Differential Diagnosis of Uveitic Macular Edema

Agarwal

Pichi

Invernizzi

et al. 2018

Ocular Immunology and Inflammation

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Uveitic cystoid macular edema (UME) is an important cause of visual morbidity among patients with both infectious and non-infectious uveitis. UME may be associated in more than 30% cases of active uveitis. However, even patients with minimal features of intraocular inflammation may develop recurrent or chronic UME. Therefore, the evaluation and management of UME in patients with uveitis may be challenging. A number of vitreoretinal pathologies may result in UME and accumulation of fluid in the intra-or subretinal space. These need to be carefully distinguished from each other so that appropriate management can be initiated. All types of uveitis, including anterior uveitis (where the primary site of inflammation is not in the posterior segment) can present with UME. Other conditions such as diabetes, and surgery, can present with macular edema. This index review highlights various differential diagnoses of UME and provides illustrative case examples with multimodal imaging evaluation.

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“…[ 2 ] There are few reports of macular hole formation following intravitreal bevacizumab injection. [ 12 13 ] Here, we report a case of bilateral lamellar macular hole formation after intravitreal bevacizumab injection for the treatment of wet-type AMD.…”

Section: Introductionmentioning

confidence: 99%

Lamellar macular hole formation following intravitreal bevacizumab injection for choroidal neovascularization by age-related macular degeneration

2018

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This report describes a lamellar macular hole formation subsequent to intravitreal bevacizumab injection for the treatment of choroidal neovascularization (CNV) by age-related macular degeneration. A 67-year-old woman with bilateral CNV underwent 3 monthly intravitreal bevacizumab injections in her both eyes. One month after the third bilateral injection, vision loss happened. Optical coherence tomography performed for further evaluation that showed reduction of intra- and sub-retinal fluid associated with lamellar macular hole development in both eyes. Although macular hole formation, especially bilateral form, is a rare complication of intravitreal injections, surgeons should consider macular hole development in cases with vision deterioration following intravitreal bevacizumab injection.

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Lamellar Macular Hole Formation in a Patient With Diabetic CME Treated by Intravitreal Bevacizumab Injections

Cited by 9 publications

References 15 publications

Vitreoretinal interface abnormalities in patients treatedwith ranibizumab for diabetic macular oedema

Vitreoretinal interface abnormalities in patients treatedwith ranibizumab for diabetic macular oedema

Disease of the Year: Differential Diagnosis of Uveitic Macular Edema

Lamellar macular hole formation following intravitreal bevacizumab injection for choroidal neovascularization by age-related macular degeneration

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