J Korean Ophthalmol Soc.  2011 Aug;52(8):1009-1012. 10.3341/jkos.2011.52.8.1009.

A Case of Choroidal Neovascularization Occurring after Macular Hole Surgery

• Kim KS
• Lee WK

• KMID: 2214783
• DOI: http://doi.org/10.3341/jkos.2011.52.8.1009

Abstract

PURPOSE
To report a case of choroidal neovascularization after successful macular hole surgery in an eye with macular drusen.
CASE SUMMARY
A 66-year-old woman visited our clinic complaining of decreased visual acuity in her right eye. Fundoscopy showed a full thickness macular hole in the right eye and bilateral scattered drusen. The patient underwent uncomplicated pars plana vitrectomy, internal limiting membrane peeling using triamcinolone, and perfluoropropane (C3F8) gas tamponade. One month after vitrectomy, the macular hole was closed. Twenty-four months following the macular hole surgery, the patient presented with defective vision in the right eye. Fluorescein angiography showed classic subfoveal choroidal neovascularization. Intravitreal bevacizumab was administrated three times in the right eye; however, visual improvement was not observed.
CONCLUSIONS
In eyes with macular hole and drusen, the possibility of choroidal neovascularization developing after macular hole surgery should be considered.

Keyword

Choroidal neovascularization; Drusen; Macular hole surgery

MeSH Terms

Aged
Antibodies, Monoclonal, Humanized
Choroid
Choroidal Neovascularization
Eye
Female
Fluorescein Angiography
Fluorocarbons
Humans
Membranes
Retinal Perforations
Triamcinolone
Vision, Ocular
Visual Acuity
Vitrectomy
Bevacizumab
Antibodies, Monoclonal, Humanized
Fluorocarbons
Triamcinolone

Figure

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  Figure 1. (A) Preoperative fundus photograph shows a full-thickness macular hole and drusen. (B) Fundus photograph of the fellow eye also shows drusen.

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  Figure 2. Postoperative images showing choroidal neovascularization (CNV). (A) Fundus photograph shows CNV lesion with fibrotic change at the macular area. (B) Early and (C) late phase fluorescein angiographs show diffuse leakage and staining in the CNV area. (D) Indocyanine green angiograph reveals chorioretinal anastomosis (arrow) at the site of the previous macular hole.

Reference

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