Abstract

THIS CASE SERIES DESCRIBES FULL-THICKNESS MACULAR HOLE FORMATION AFTER INTRAVITREAL RANIBIZUMAB INJECTION FOR RETINAL VEIN OCCLUSION. ONLY LIMITED CASE REPORTS HAVE REPORTED THIS TYPE OF UNEXPECTED ADVERSE EVENT AFTER INTRAVITREAL ANTI-VEGF INJECTION.
POSSIBLE MECHANISMS COULD BE TANGENTIAL SHEARING FORCES ON THE POSTERIOR POLE DUE TO CONTRACTION AND RAPID VOLUME REDUCTION OF THE INTRA OR SUBRETINAL FLUID, FOCAL TRACTIONAL FORCES ON THE VITREORETINAL INTERFACE DUE TO GLOBE DEFORMATION DURING NEEDLE INSERTION, VITREOUS SYNERESIS, PREXCISTING FOCAL VMT OR MAY BE TOXIC EFFECT OF ANTI-VEGF AGENTS ON A PREVIOUSLY COMPROMISED RETINA.
THE ADVERSE EFFECT WAS MANAGED BY SURGICAL INTERVENTION FOLLOWED BY REPEATED INTRAVITREAL DEX IMPLANTS AND TARGETED PHOTOCOAGULATION OF THE RETINA.
RETROSPECTIVELY WE NOTICED ALL CASES HAVE PRE-EXISTING VMT, WHICH COULD HAVE BEEN MANAGED BY GIVING STT INJECTION WITH TARGETED LASER APPLICATION AND MAY AVOID INTRAVITREAL ANTIVEGF INJECTION IN SUCH CASES BLINDLY.

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