title: Vitrectomy after anti-VEGF therapy for epiretinal membranes coincident with age-related subfoveal choroidal neovascularization.
abstract: OBJECTIVE
  To report the visual acuity results in a small case series of eyes undergoing membrane peeling for epiretinal membrane presenting with age-related subfoveal choroidal neovascularization.
  
  
  METHODS
  Retrospective chart review of all eyes undergoing vitrectomy with epiretinal membrane peeling after intravitreal anti-vascular endothelial growth factor injection treatment for age-related subfoveal choroidal neovascularization presenting between February 2005 and January 2007 to a private vitreoretinal subspecialty practice.
  
  
  RESULTS
  Four eyes of four patients observed for 10-23 months (median = 20.5 months) were identified. All eyes presented with an angiographically ill-defined choroidal neovascular membrane and epiretinal membrane by optical coherence tomography. After anti-vascular endothelial growth factor therapy, visual acuity improved 1 to 5 Snellen lines (median = 2 lines). After vitrectomy, visual acuity further improved 1 to 6 lines (median = 2 lines). Final visual acuity was unchanged in 1 eye and improved in 3 eyes, with an overall improvement of 0 to 7 Snellen lines (median = 3.5 lines) after 5 to 14 months (median = 8 months) of follow-up following the vitrectomy.
  
  
  CONCLUSIONS
  In selected eyes presenting with epiretinal membrane and age-related subfoveal choroidal neovascularization after anti-vascular endothelial growth factor therapy, pars plana vitrectomy with membrane peeling may offer further improvement in visual acuity.
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Luttrull
authors.forename: Charles
authors.initials: C
authors.lastname: Spink
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide / Q000627:therapeutic use; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D003131:Combined Modality Therapy; D019773:Epiretinal Membrane / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis; D006801:Humans; D007267:Injections; D008297:Male; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib; D000068258:Bevacizumab