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Ando T, Kubota M, Yasukawa T, Miyase T, Ishiguro K, Esaki Y, Kato A, Kokuzawa S, Hirano Y, Sakaguchi H. Macular hole with retinal pigment epithelium tear after anti-VEGF therapy in an eye with neovascular age-related macular degeneration. Am J Ophthalmol Case Rep 2024; 36:102126. [PMID: 39149619 PMCID: PMC11324838 DOI: 10.1016/j.ajoc.2024.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 06/26/2024] [Accepted: 07/12/2024] [Indexed: 08/17/2024] Open
Abstract
Purpose To report a case of a full-thickness macular hole (FTMH) associated with a retinal pigment epithelium (RPE) tear after anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nvAMD), which was successfully closed by vitreous surgery. Observations A 73-year-old man with nvAMD in the right eye received an intravitreal aflibercept injection due to enlarged pigment epithelial detachment. However, 2 days after the third injection, the patient experienced a sudden decline in vision. An FTMH with a tear in the underlying RPE was detected. The FTMH was closed using vitrectomy combined with the inverted internal limiting membrane (ILM) flap technique. Conclusions and Importance Our case highlights a rare complication of both an FTMH and an RPE tear after anti-VEGF therapy. Vitrectomy, with the inverted ILM flap technique, proved effective in closing the FTMH despite the complexity of the case.
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Affiliation(s)
- Tomoko Ando
- Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, Gifu, 501-1194, Japan
| | - Masaomi Kubota
- Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, Gifu, 501-1194, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Taishi Miyase
- Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, Gifu, 501-1194, Japan
| | - Kiyona Ishiguro
- Department of Ophthalmology, Ogaki Tokushukai Hospital, Ogaki, Gifu, Japan
| | - Yuya Esaki
- Department of Ophthalmology, Ogaki Tokushukai Hospital, Ogaki, Gifu, Japan
| | - Aki Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Satoko Kokuzawa
- Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, Gifu, 501-1194, Japan
| | - Yoshio Hirano
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Hirokazu Sakaguchi
- Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, Gifu, 501-1194, Japan
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Hashimoto Y, Arai Y, Makino S, Inoue Y, Takahashi H, Kawashima H. Full-Thickness Macular Hole with Coats Disease: A Case Report. Case Rep Ophthalmol 2020; 11:342-347. [PMID: 32884548 PMCID: PMC7443633 DOI: 10.1159/000508821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/20/2020] [Indexed: 11/19/2022] Open
Abstract
We report a case of full-thickness macular hole (FTMH) which developed during follow-up for Coats disease. To our knowledge, this is the first report on a case of FTMH which developed during follow-up for Coats disease. A 17-year-old boy was referred to our institution with blurred vision in his left eye. Fundus examination showed yellowish subretinal exudates with overlying telangiectatic retinal vessels in the temporal periphery in the left eye; the right eye was normal. Fluorescein angiography revealed diffusion indicative of temporal peripheral vascular leakage. We made a diagnosis of stage 2A Coats disease and performed argon laser photocoagulation (PC). Moreover, he received intravitreal injection of anti-vascular endothelial growth factor. At 30 months after the first visit, the best-corrected visual acuity (BCVA) of the left eye worsened to 20/50. We observed tensioned internal limiting membrane (ILM), serous macular detachment (SMD) and retinal thinning; the intraretinal exudate remained. We performed PC and at 36 months after the first visit, BCVA further declined to 20/63 in his left eye and FTMH was observed. We then performed a 27-gauge pars plana vitrectomy and ILM peeling following which the FTMH was found to have closed by 4 days after vitrectomy. SMD gradually decreased, and BCVA improved to 20/20. Chronic inflammation by peripheral vascular leakage and PC application might have caused FTMH. In this case, the vitrectomy for FTMH with Coats disease provided good visual and anatomic outcomes.
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Affiliation(s)
| | - Yusuke Arai
- Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Japan
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