Full-thickness macular hole formation following anti-VEGF injections for neovascular age-related macular degeneration

• Published in: Clinical interventions in aging Vol. 12; pp. 911 - 915
• Main Authors: Kabanarou, Stamatina A, Xirou, Tina, Mangouritsas, George, Garnavou-Xirou, Christina, Boutouri, Eirini, Gkizis, Ilias, Chatziralli, Irini
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2017; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Age; age-related macular degeneration; Aged; Angiogenesis inhibitors; anti-VEGF; Case Series; Complications and side effects; Development and progression; Diabetic retinopathy; Dosage and administration; Drug therapy; Elderly; Female; Females; Health aspects; Humans; Intravitreal Injections; Macular degeneration; Macular Degeneration - drug therapy; macular hole; Male; Medical imaging; Middle Aged; Pathogenesis; Patients; Retinal diseases; Retinal Perforations - chemically induced; Retrospective Studies; Risk factors; Tomography, Optical Coherence; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - adverse effects; Vascular Endothelial Growth Factor A - therapeutic use; Visual Acuity; Greece; Germany; anti-VEGF; macular hole; age-related macular degeneration
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S135364

Macular hole (MH) is part of a group of age-related degenerative diseases characterized by pathology of vitreomacular interface. Similarly, neovascular age-related macular degeneration (nAMD) affects older patients and is a leading cause of irreversible visual loss. The purpose of this case series is to describe the development of full-thickness MH in patients with nAMD, following antivascular endothelial growth factor (anti-VEGF) treatment.
Participants in this case series were four patients with nAMD, who received anti-VEGF injections with variable therapeutic response to treatment. Patients were examined at baseline (when AMD was diagnosed) and monthly thereafter. The examination included visual acuity measurement, slit-lamp biomicroscopy, and optical coherence tomography.
All patients were found to develop full-thickness MH within 1-4 months after the last anti-VEGF injection, even in the absence of pre-existing vitreomacular interface abnormalities in some cases. The median number of injections before the MH formation was 3.
MH formation may represent an adverse effect of anti-VEGF treatment in patients with nAMD and could be also coexisting pathology with nAMD in older individuals.