Karamitsos Athanasios, Sorkou Konstantina N, Bhagey Joy, Hillier Roxane J, Papastavrou Vasileios T
2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, GRC.
The Newcastle Eye Department, Royal Victoria Infirmary, Newcastle, GBR.
Cureus. 2021 Jan 23;13(1):e12872. doi: 10.7759/cureus.12872.
Aflibercept is an intravitreally injected anti-vascular endothelial growth factor, commonly used in patients with several retinal pathologies, including neovascular age-related macular degeneration. We report a case series of three patients under treatment with an aflibercept regime for neovascular age-related macular degeneration, who were referred to vitreoretinal service between 2015-2016. In all cases, pre-existing vitreomacular traction was detected with an optical coherence tomography scan. All of them developed full-thickness macular hole after aflibercept intravitreal injections. The combined cataract and macular hole surgery was successful, with improvement in visual acuity. We suggest that dynamic alterations of the size of the pigment epithelium detachment resulting from intravitreal injections might intensify the pre-existing pathological adhesion of the vitreous-retinal interface and subsequently cause the formation of a full-thickness macular hole. Therefore, all practitioners treating patients with aflibercept intravitreal injections and pre-existing vitreomacular traction should be aware of the possible macular hole formation.
阿柏西普是一种玻璃体内注射的抗血管内皮生长因子，常用于患有多种视网膜病变的患者，包括新生血管性年龄相关性黄斑变性。我们报告了一组3例接受阿柏西普治疗新生血管性年龄相关性黄斑变性的病例系列，这些患者于2015年至2016年被转诊至玻璃体视网膜科。在所有病例中，通过光学相干断层扫描检测到术前存在玻璃体黄斑牵拉。所有患者在玻璃体内注射阿柏西普后均出现了全层黄斑裂孔。白内障联合黄斑裂孔手术成功，视力得到改善。我们认为，玻璃体内注射导致色素上皮脱离大小的动态变化可能会加剧先前存在的玻璃体-视网膜界面的病理性粘连，进而导致全层黄斑裂孔的形成。因此，所有为存在玻璃体黄斑牵拉且接受玻璃体内注射阿柏西普治疗的患者进行治疗的医生都应意识到可能形成黄斑裂孔。
