Removal of choroidal neovascular membrane in a case of macular hole after anti-VEGF therapy for age-related macular degeneration.
Removal of choroidal neovascular membrane in a case of macular hole after anti-VEGF therapy for age-related macular degeneration.
复制标题
抗VEGF治疗后，在与年龄相关的黄斑变性后，在黄斑孔中去除脉络膜新生血管膜。
DOI：
10.1016/j.ajoc.2017.12.003
复制
发表时间：
2018-03
影响因子：
--
通讯作者：
Nakamura KI
中科院分区：
文献类型：
--
作者：
Hirata A;Hayashi K;Murata K;Nakamura KI
接受抗血管内皮生长因子(anti-VEGF)治疗后形成黄斑裂孔的情况很少见。我们报告一位接受玻璃体切除联合脉络膜新生血管(CNV)切除的老年性黄斑变性(AMD)患者在玻璃体内注射抗血管内皮生长因子药物后发生黄斑裂孔的病例。，一名患有老年性黄斑变性右眼的女性，接受了玻璃体内注射抗血管内皮生长因子药物。治疗后，我们发现了一个全层黄斑裂孔(MH)，这与黄斑水肿和CNV收缩的快速缓解有关。玻璃体切除联合CNV摘除后，MH闭合，视力提高。对摘除的CNV的检查显示，微血管网络中没有周细胞。目前的研究结果表明，抗血管内皮生长因子治疗后黄斑水肿和CNV收缩的迅速消退和/或玻璃体牵引力的轻微增加可能会导致MH。如果MH仍然开放，CNV是经典的类型，并且保留了中心凹的一部分，那么通过MH去除CNV可能是一种可以接受的方法。
The formation of macular hole after receiving anti-vascular endothelial growth factor (anti-VEGF) therapy is rare. We report a case of macular hole that occurred after intravitreal injection of an anti-VEGF agent for age-related macular degeneration (AMD) in a patient, who underwent vitrectomy combined with choroidal neovascularization (CNV) removal. A 64-year-old female with AMD affecting her right eye received an intravitreal injection of an anti-VEGF agent. After treatment, we identified a full thickness macular hole (MH) that was associated with the rapid resolution of the macular edema and contraction of the CNV. After performing vitrectomy combined with CNV removal, the MH closed and her visual acuity improved. Examination of the removed CNV revealed a network of microvessels devoid of pericytes. The present findings suggest that rapid resolution of macular edema and contraction of the CNV and/or mild increase in the vitreous traction after anti-VEGF therapy could potentially cause MH. CNV removal via the MH may be an acceptable procedure, if the MH remains open, the CNV is of the classic type, and it spares a central portion of the fovea.