title: OUTCOMES OF ANTI-VEGF THERAPY IN CHOROIDAL NEOVASCULARIZATION AFTER MACULAR SURGERY.
abstract: OBJECTIVE
  To report treatment outcomes of anti-vascular endothelial growth factor (VEGF) therapy in choroidal neovascularization (CNV) presenting after macular surgery.
  
  
  METHODS
  Retrospective analysis of 7 eyes of 7 patients, who were diagnosed to have CNV after macular surgery and were treated with anti-vascular endothelial growth factor therapy. Collected data included demographic details; history of present illness; surgical procedure; and clinical examination including visual acuity at presentation and follow-up with imaging and management. Main outcome measures were resolution of CNV activity at the last follow-up. Secondary outcomes included change in visual acuity at final follow-up from baseline, number of injections, treatment free interval, and adverse events.
  
  
  RESULTS
  Seven eyes of 7 patients (2 females and 5 males), which underwent macular surgery (4 macular hole repairs and 3 epiretinal membrane (ERM) removal), were included in this study. Two eyes had drusen at the time of surgery; however, five eyes had no preexisting conditions. Mean interval between surgery and CNV development was 21.07 ± 38.55 months (range, 2 months-9 years). All patients had undergone intravitreal anti-vascular endothelial growth factor injections (range, 2-15; mean number: 5.85) with one eye requiring additional photodynamic therapy (PDT) and focal laser. Visual acuity was unchanged with inactive CNV at the last visit in all eyes after anti-vascular endothelial growth factor therapy. The mean follow-up duration after the development of CNV was 35.5 months (range, 6.5 months-8 years).
  
  
  CONCLUSIONS
  Choroidal neovascularization occurring after otherwise successful macular surgery is uncommon with unknown predisposing factors. This entity appears to have poor visual outcome with currently available anti-vascular endothelial growth factor therapy.
authors.affiliation: Srimati Kanuri Santhamma Retina Vitreous Center, Kallam Anji Reddy Campus, L. V. Prasad Eye Institute, Hyderabad, India.|Ho Chi Minh City Eye Hospital, Ho Chi Minh City, Vietnam.
authors.forename: Duc Anh
authors.initials: DA
authors.lastname: Hua
authors.affiliation: Department of Ophthalmology, State University of Londrina, Londrina, Brazil.
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Casella
authors.affiliation: Department of Ophthalmology, University of Puezrto Rico, San Juan, Puerto Rico.
authors.forename: Maria H
authors.initials: MH
authors.lastname: Berrocal
authors.affiliation: Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Dennis
authors.initials: D
authors.lastname: Han
authors.affiliation: Department of Ophthalmology, McGill University, Montreal, Quebec, Canada.
authors.forename: Rayan A
authors.initials: RA
authors.lastname: Alshareef
authors.affiliation: University of Colorado, School of Medicine, Denver, Colorado.
authors.forename: Hugo
authors.initials: H
authors.lastname: Quiroz-Mercado
authors.affiliation: Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Arevalo
authors.affiliation: Srimati Kanuri Santhamma Retina Vitreous Center, Kallam Anji Reddy Campus, L. V. Prasad Eye Institute, Hyderabad, India.
authors.forename: Jay
authors.initials: J
authors.lastname: Chhablani
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D006801:Humans; D008266:Macula Lutea / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D011993:Recombinant Fusion Proteins; D012167:Retinal Perforations / Q000601:surgery*; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab