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Occult choroidal neovascularization after successful macular hole surgery treated with ranibizumab

Authors Oh, Lee JE, Kim, Yang, Yun IH

Received 6 May 2012

Accepted for publication 26 June 2012

Published 10 August 2012 Volume 2012:6 Pages 1287—1291

DOI https://doi.org/10.2147/OPTH.S33650

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5


Ha Na Oh,1 Joo Eun Lee,2 Hyun Woong Kim,1 Jae Wook Yang,1 Il Han Yun1

1Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea; 2Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea

Purpose: To report on a case that developed an atypical form of occult choroidal neovascularization (CNV) after successful macular hole surgery.
Methods: Visual acuity change, color fundus photographs, fluorescein and indocyanine green angiograms, and optical coherence tomography results were compared throughout the follow-up duration.
Patients: A 64-year-old woman with a macular hole in the right eye and drusen in both eyes underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. One month after the operation she developed occult CNV, in which pigment epithelial detachment and fine retinal pigment epithelial (RPE) layer wrinkles were observed under the completely sealed macular hole. After 3-monthly intravitreal injections of ranibizumab, the lesion did not change significantly.
Conclusion: CNV can develop after otherwise successful macular hole surgery, especially in patients with pre-existing aging changes in the macula, such as drusen. Care should be taken in such patients, to prevent the development of CNV after macular hole surgery.

Keywords: drusen, macular hole surgery, occult choroidal neovascularization, ranimizumab injection

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