Hui Maggie, Gunzenhauser Robert, Dillon Alexander, Tsui Irena
UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
West Los Angeles Veterans Affairs Hospital, Los Angeles, CA, USA.
Case Rep Ophthalmol. 2024 Jun 28;15(1):525-531. doi: 10.1159/000537777. eCollection 2024 Jan-Dec.
We present a case of a patient with preceding vitreomacular traction (VMT) who developed a full-thickness macular hole (FTMH) following his sixth intravitreal aflibercept injection for the treatment of age-related macular degeneration and review the literature on risk factors and pathogenesis of this adverse event.
FTMH can occur after an extended number of repeat intravitreal injections in the setting of worsening vitreomacular adhesion or VMT. This patient's FTMH was successfully treated surgically in a timely manner, and additional injections were resumed safely.
Patients with an unexpected decrease in vision after intravitreal injections should be reevaluated with optical coherence tomography to rule out alternative pathology including vitreomacular interface abnormalities. FTMH, if present, should be treated promptly to allow for resumption of therapy as needed and visual optimization.
我们报告一例先前患有玻璃体黄斑牵引（VMT）的患者，在其接受第六次玻璃体内注射阿柏西普治疗年龄相关性黄斑变性后出现了全层黄斑裂孔（FTMH），并回顾了关于该不良事件的危险因素和发病机制的文献。
在玻璃体黄斑粘连或VMT恶化的情况下，多次重复玻璃体内注射后可能会发生FTMH。该患者的FTMH通过手术及时成功治疗，并且安全地恢复了额外的注射。
玻璃体内注射后视力意外下降的患者应通过光学相干断层扫描重新评估，以排除包括玻璃体黄斑界面异常在内的其他病变。如果存在FTMH，应及时治疗，以便根据需要恢复治疗并优化视力。
