A rare case of choroidal neovascularization following macular hole surgery.
BACKGROUND
Choroidal neovascularization occurs in a wide spectrum of conditions, including degenerative, inflammatory, traumatic and hereditary conditions, all of which are characterized by breaks in Bruch's membrane. A few cases of choroidal neovascular membrane (CNVM) have been reported in the literature following macular hole surgery.


METHODS
We present a retrospective case study of a single patient who developed CNVM after successful macular hole surgery. The 70-year-old diabetic female underwent macular hole surgery in her right eye. Posterior hyaloid was separated with suction and vitrectomy was performed. Internal limiting membrane (ILM) was stained with trypan blue under air and ILM peeling was performed. Perfluoropropane (C3F8) gas was used as the tamponade. Six weeks post-operation, closure of macular hole was seen. Six months later, she presented with defective vision. Subfoveal classic CNVM was seen in the same eye.


CONCLUSIONS
About 1%-3% of patients who undergo macular hole surgery develop CNVM. Age-related changes and surgical trauma are considered to be the predisposing factors in reported cases. Injury to the retinal pigment epithelium (RPE) during surgery may be an important factor in our case, since there were no pre-existing age-related changes.


CONCLUSIONS
CNVM though rare can occur after macular hole surgery, especially in the setting of age-related changes. Injuries to the RPE should be avoided during surgery. We report a case of CNVM after macular hole in which trypan blue was used as a staining agent.
Natarajan
S
S
Aditya Jyot Eye Hospital Pvt. Ltd., Plot No. 153, Road No. 9, Major Parmeshwaran Road, Opp. SIWS College Gate No. 3, Mumbai, Wadala, 31, India. ajeh@vsnl.com
Mehta
Hitendra B
HB
Mahapatra
Santosh Kumar
SK
Sharma
Sumita
S
D000368:Aged; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D010778:Photochemotherapy; D011183:Postoperative Complications; D012167:Retinal Perforations / Q000601:surgery*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren