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FULL-THICKNESS MACULAR HOLE AFTER INTRAVITREAL ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR IN A CASE WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
全層性黃斑部裂孔為老年黃斑部病變經眼內注射抗血管內皮生長因子藥物後之潛在併發症－病例報告
摘要
目的：描述一個個案在施打抗血管內皮生長因子藥物後產生黃斑部裂孔。方法：病例報告。結果：一位66 歲男性左眼視力僅於眼前辨指數，眼底斷層掃描顯示有脈絡膜新生血管，網膜色素外皮層分離及大量的黃斑部下積水。彩色眼底攝影則發現有黃斑部下出血及新生血管。眼底螢光血管攝影可以見到新生血管所造成之滲漏及出血所造成之螢光遮蔽，因此診斷為新生血管性老年性黃斑部病變。在替病人施打眼內注射癌思停 1.25 毫克之一個月後，黃斑部下積水，網膜色素外皮層分離及脈絡膜新生血管皆有改善，視力也進步至20/400。之後又再次施打眼內注射樂舒晴0.5 毫克，一個月後追蹤卻發現有全層性黃斑部裂孔及視力退步至僅餘眼前辨指數。結論：我們認為黃斑部裂孔為新生血管性老年性黃斑部病變施打抗血管內皮生長因子藥物潛在之併發症。
關鍵字
無資料並列摘要
Purpose: To present a case who developed a full-thickness macular hole after the administration of intravitreal anti-vascular endothelial growth factor (VEGF) injections. Methods: Case report. Results: A 66-year-old man had poor visual acuity of only counting fingers in the left eye. Optical coherence tomography revealed choroidal neovascularization (CNV) and a retinal pigment epithelial detachment, as well as a massive collection of submacular fluid. Fundus photography revealed a submacular hemorrhage and neovascularization. Fundus fluorescein angiography demonstrated a macular leakage because of CNV and blocked fluorescence secondary to a submacular hemorrhage. The patient was diagnosed with neovascular age-related macular degeneration (AMD), so a single intravitreal injection of bevacizumab, 1.25 mg, was administered. The submacular fluid and retinal pigment epithelial detachment disappeared; his CNV regressed; and his vision improved to 20/400 within 1 month of the bevacizumab treatment. A subsequent intravitreal injection of ranibizumab, 0.5 mg, was administered 1 month after the bevacizumab injection. A full-thickness macular hole and regressed CNV were discovered 1 month after the ranibizumab injection, and his vision deteriorated to counting fingers. Conclusion: A macular hole is a potential complication of the intravitreal administration of anti-VEGF agents for patients with neovascular AMD.
延伸閱讀
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