J Retin.  2021 Nov;6(2):155-161. 10.21561/jor.2021.6.2.155.

Development of Subretinal Hemorrhage during Treatment of Neovascular Age-related Macular Degeneration Using a Treat-and-extend Regimen: A Case Report

• Kim JH

• KMID: 2552184
• DOI: http://doi.org/10.21561/jor.2021.6.2.155

Abstract

Purpose
To report a case of subretinal hemorrhage that developed during treatment of neovascular age-related macular degeneration (nAMD) using a treat-and-extend (TAE) regimen.
Case summary
A 69-year-old woman was diagnosed with nAMD. Three monthly ranibizumab injections were performed as an initial treatment. Then, treatment was performed as-needed for 32 months. At 32 months, the treatment regimen was switched to TAE, which is characterized by continuous injections with 1 to 3 months interval regardless of recurrence. During the 31-month TAE period, 14 anti-vascular endothelial growth factor injections were performed. At 31 months, the injection interval was 2 months, and no subretinal or intraretinal fluid was observed on optical coherence tomography. Best-corrected visual acuity (BCVA) was 0.2. At 33 months, subretinal hemorrhage developed with deterioration of BCVA to 0.04. Three ranibizumab injections were performed, but subretinal hemorrhage did not resolve.
Conclusions
Extensive subretinal hemorrhage can develop even in patients treated with TAE regimen. Further studies are required to more effectively prevent the hemorrhage.

Keyword

Age related macular degeneration; Choroidal neovascularization; Retinal hemorrhage