High incidence of vitreomacular traction in recurrent choroidal neovascularisation after repeated photodynamic therapy.
BACKGROUND
The causes of recurrent choroidal neovascularisation (CNV) after photodynamic therapy (PDT) remain controversial. Subretinal surgery was carried out after unsuccessful PDT.


OBJECTIVE
To determine intraoperatively the status of the posterior vitreous interface.


METHODS
Interventional case series.


METHODS
Conventional three-port vitrectomy was carried out in 10 eyes with CNV that had undergone 1-4 PDT sessions. The vitreous cutter was held close to the edge of the optic nerve to evaluate the status of the posterior vitreous.


RESULTS
Lesion size showed an increase from 1.5 (standard deviation (SD) 0.53) to 2.3 (SD 0.83) macular photocoagulation study disc diameters, between the first and the last PDT. Intraoperative findings during vitrectomy showed little liquefaction of the vitreous gel and an incomplete posterior-vitreous detachment, with remarkably firm attachments at the macula in all cases (10/10).


CONCLUSIONS
We determined an abnormally high incidence of vitreous attachments in eyes with recurrent CNV. Vitreomacular attachments may trigger the progression or recurrence of CNV.
Schmidt
J C
JC
Department of Ophthalmology, Philipps-University Marburg, Robert-Koch-Strasse 4, 35037 Marburg, Germany.
Mennel
S
S
Hörle
S
S
Meyer
C H
CH
D000328:Adult; D000368:Aged; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008266:Macula Lutea / Q000473:pathology / Q000601:surgery*; D008268:Macular Degeneration / Q000188:drug therapy* / Q000601:surgery; D008875:Middle Aged; D010778:Photochemotherapy; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D000267:Tissue Adhesions / Q000601:surgery; D014822:Vitreous Body / Q000473:pathology / Q000601:surgery*