Korean J Ophthalmol.  2007 Sep;21(3):185-187. 10.3341/kjo.2007.21.3.185.

Retinal Detachment with Macular Hole Following Combined Photodynamic Therapy and Intravitreal Bevacizumab Injection

• Chung EJ
• Koh HJ

• KMID: 1099038
• DOI: http://doi.org/10.3341/kjo.2007.21.3.185

Abstract

PURPOSE: To report a case of retinal detachment with a macular hole following photodynamic therapy (PDT) using verteporfin and intravtreal bevacizumab injection in the treatment of myopic choroidal neovasclarization (CNV). METHODS: A 58 -year-old woman was diagnosed with myopic CNV and treated with a combination of PDT with verteporfin and intravitreal bevacizumab injection that same day. She received the second injection of intravitreal bevacizumab four weeks after the initial treatment. RESULTS: The patient developed a sudden decline in vision one week after the second injection; and was subsequently diagnosed with retinal detachment associated with a macular hole. She underwent standard three-port pars plana vitrectomy with internal limiting membrane peeling, fluid-air exchange and silicone oil injection. The retina was still firmly attached at the patient's final follow-up visit. CONCLUSIONS: PDT and intravitreal bevacizumab injection used for the treatment of myopic CNV can be associated with retinal detachment with a macular hole. Patients need to be informed about this potential complication, and a higher index of suspicion may be warranted in patients who report sudden vision loss after the treatment.

Keyword

Intravitreal bevacizumab injection; Macular hole detachment; Photodynamic therapy

MeSH Terms

Angiogenesis Inhibitors/administration & dosage/*adverse effects/therapeutic use
Antibodies, Monoclonal/administration & dosage/*adverse effects/therapeutic use
Choroidal Neovascularization/*drug therapy
Female
Humans
Injections
Middle Aged
Photochemotherapy/*adverse effects
Retinal Detachment/*etiology
Retinal Perforations/*etiology
Vitreous Body

Figure

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  Fig. 1 (A) Fundus photography of the right eye before treatment demonstrates a juxtafoveal grayish subretinal membrane with subretinal fluid and hemorrhage. (B) Late phase of the fluorescein angiography shows diffuse leakage from a juxtafoveal choroidal neovascularization.

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  Fig. 2 (A) Fundus photography 5 weeks after initial combined treatment of PDT and intravitreal bevacizumab, and 1 week after the second intravitreal bevacizumab injection; demonstrating serous retinal detachment of the posterior pole with a macular hole. (B) OCT confirms the presence of a macular hole.

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