The impact of removing the epiretinal membrane and inner limiting membrane for sustained subretinal fluid by macular neovascularization refractory to anti-VEGF therapy

去除视网膜前膜和内界膜对持续性视网膜下液的影响,适用于抗VEGF治疗无效的黄斑新生血管性视网膜病变

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Abstract

PURPOSE: Anti-vascular endothelial growth factor (VEGF) therapy is the most prevalent intervention for exudative lesions secondary to neovascular age-related macular degeneration (nAMD) and other macular neovascularization (MNV). However, in some cases refractory to the latest anti-VEGF agents is associated with epiretinal membrane (ERM) or vitreomacular traction. We applied a vitrectomy to remove those pathologies which may be effective for reducing the exudation. OBSERVATIONS: In this case report, we present 2 cases with sustained subretinal fluid and macular neovascularization secondary to nAMD or dome-shaped macula that poorly responded to anti-VEGF therapy. In both cases, removing thin ERM or vitreomacular traction with an inner limiting membrane peeling promptly resolved the subretinal fluid and no recurrence was observed thereafter. CONCLUSIONS AND IMPORTANCE: Vitrectomy could be an effective modality for anti-VEGF drug-resistant MNV cases with vitreomacular traction or ERM even in the anti-VEGF era.

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