Otsuka Keiko, Imai Hisanori, Shimoyama Tsuyoshi, Nagai Takayuki, Honda Shigeru, Azumi Atsushi
Department of Ophthalmology, Kobe Kaisei Hospital, Kobe, Japan.
Case Rep Ophthalmol. 2012 Sep;3(3):424-7. doi: 10.1159/000346041. Epub 2012 Dec 18.
To report a case who had recurrence of macular hole retinal detachment (MHRD) after intravitreal ranibizumab injection (IVR) for the treatment of choroidal neovascularization (CNV) that arose from the damaged retinal pigment epithelium of the remaining macular hole (MH) edge, which had been successfully treated by pars plana vitrectomy (PPV) 15 years previously.
A 67-year-old man with previous PPV for MHRD secondary to high myopia in the right eye had been under observation for 15 years after surgery. The retina had been successfully attached, but the MH remained open. He had CNV which arose from the remaining MH edge. IVR was performed for the treatment of CNV. One month after the injection, CNV was contracted but recurrence of MHRD occurred. PPV with an additional internal limiting membrane peeling, removal of the CNV membrane and 20% SF6 gas tamponade was performed. One year after the last surgery, his right retina was attached and the MH was closed successfully.
We propose that patients who undergo IVR should be carefully maintained and followed up for possible complications including the recurrence of MHRD.
报告1例患者，其因脉络膜新生血管（CNV）接受玻璃体内注射雷珠单抗（IVR）治疗，该CNV由15年前成功接受玻璃体切割术（PPV）治疗的残余黄斑裂孔（MH）边缘受损的视网膜色素上皮引起，注射后出现黄斑裂孔视网膜脱离（MHRD）复发。
一名67岁男性，右眼因高度近视继发MHRD曾接受PPV治疗，术后已观察15年。视网膜已成功复位，但MH仍未闭合。他出现了源于残余MH边缘的CNV。对CNV进行IVR治疗。注射后1个月，CNV缩小，但发生了MHRD复发。进行了PPV，额外行内界膜剥除、CNV膜切除及20%的六氟化硫（SF6）气体填充。最后一次手术后1年，其右眼视网膜复位，MH成功闭合。
我们建议，接受IVR治疗的患者应得到仔细的监护及随访，以预防包括MHRD复发在内的可能并发症。
