Purchase this article with an account.
Nauman A. Chaudhry, Homayoun Tabandeh, Harry W. Flynn, Jr., Veronica Konjara, Peter E. Liggett; Spontaneous Development And Closure Of Full Thickness Macular Hole During Intravitreal Anti-VEGFf Therapy For Neovascular Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):858.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Spontaneous full thickness macular hole (FTMH) has been reported during intravitreal anti-VEGF therapy for neovascular age-related macular degeneration (nvAMD) . We describe the development and spontaneous closure of FTHM during anti-VEGF therapy for nvAMD.
Retrospective observational case series. Four eyes of 4 patients with nvAMD treated by anti-VEGF therapy who developed FTMH while undergoing intravitreal anti-VEGF therapy for nvAMD. Best-corrected Snellen visual acuity (BCVA) and OCT exam of the macula were available for each office visit. Eyes with lamellar macular holes or vitreomacular traction were excluded.
Mean duration of anti-VEGF treatment before the development of FTMH was 18 months (3 to 28 monhts). All eyes had documented preexisting posterior vitreous detachments and had active nvAMD. Mean decline in BCVA with the development of FTMH was 2 lines. All FTMHs were classified as small (200 to 300 microns). Subretinal fluid was present in 2 eyes and the remaining two had elevated pigment epithelial detaachments. Intravitreal anti-VEGF therapy was continued monthly. All eyes showed closure of FTMH within 4 months (mean 3 months). Visual improvement was observed in only one eye (2 lines). Three of the four eyes had final BCVA of 20/100 or better. Mean post-closure follow-up was 22 months (mean 9 to 37 months). Two eyes developed recurrent subretinal fluid and required additional anti-VEGF therapy but the FTMH remained closed.
In the current study, spontaneous closure of FTMH was observed in all study eyes within four months of development. Initial observation may be reasonable in these eyes especially when intravitreal therapy is being continued for nvAMD. Visual outcomes appear to be variable and partly limited by the underlying nvAMD. It is currently unknown whether these results may be applicable to eyes with larger FTMH.
This PDF is available to Subscribers Only