Abstract
BackgroundDrusen are important risk factor for neovascular age-related macular degeneration (AMD) and have a dynamic nature as they can enlarge, newly form, or disappear over time. There have been few reports on drusen regression or choroidal neovascularization (CNV) development after macular hole surgery. We report, to our knowledge, the first case of both drusen regression and subsequent CNV development within 7 months of successful macular hole surgery.Case presentationA 73-year-old woman presented with a stage 3 full-thickness macular hole and large, confluent soft macular drusen in the right eye and a neovascular age-related macular degeneration (AMD) in the fellow eye. Four months after the successful macular hole surgery, significant regression of drusen was seen, especially in the temporal area to the fovea. Three months later, the patient developed CNV and her best-corrected visual acuity decreased to 20/100, despite further regression of macular drusen.ConclusionsMacular hole patients with macular soft drusen need to be carefully followed up after surgery for possible drusen regression and CNV development.
Highlights
Drusen are important risk factor for neovascular age-related macular degeneration (AMD) and have a dynamic nature as they can enlarge, newly form, or disappear over time
Large, soft drusen are associated with a greater risk for developing advanced age-related macular degeneration (AMD), including choroidal neovascularization (CNV) and geographic atrophy [1]
We report a patient who showed a rapid regression of soft macular drusen and the development of CNV within 7 months of successful macular hole surgery
Summary
Soft drusen are associated with a greater risk for developing advanced age-related macular degeneration (AMD), including choroidal neovascularization (CNV) and geographic atrophy [1]. Ophthalmological examinations including funduscopy, fluorescein/ indocyanine green angiography and spectral-domain optical coherence tomography (OCT) showed a stage 3 full-thickness macular hole and large, confluent soft drusen in the right eye and a neovascular AMD in the left eye, for which she had undergone four sessions of intravitreal ranibizumab injections in other hospital (Figure 1A,B). Her best-corrected visual acuity (BCVA) was 20/63 in the right eye and 20/50 in the left eye. Her fellow eye CNV recurred and she was treated with additional intravitreal ranibizumab injections in both eyes
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