Long‐term outcome following ranibizumab treatment for CNV related to ND: YAG‐Laser macular injury

Abstract

PurposeTo present a case of a macular injury caused by Nd: YAG laser, the early clinical findings, the late complications and the anatomic and functional status after treatment with intravitreal ranibizumab in a five year follow‐up period.MethodsA 32‐year‐old man working on the physics laboratory, suffered a macula injury in his right eye after accidental exposure of a 800 nm wave length Nd: YAG laser pulse. His measured best corrected visual acuity on the day of the accident was 0.70 logMAR. One month later the formation of a full‐thickness macular hole was observed. Any surgical intervention was postponed and a close monitor was proposed. A spontaneous closure of the hole was observed within the next month and the vision improved to 0.18 logMAR. Six months later the patient presented with sudden deterioration of his visual acuity again measured 0.70 logMAR. OCT and FA performed, which revealed macular oedema and hemorrhage due to choroidal neovascularisation. A single intravitreal injection of ranibizumab was applied to the affected eye.ResultsThe oedema resolved within 45 days after the injection and the visual acuity improved to 0.48 logMAR. No regression was noticed and the BCVA and the macula area remain stable for a period of four and a‐half years after the resolution of the oedema,ConclusionsAll personnel working with laser products should take the necessary precautions and use protective goggles. In the event of a macular hole formation, spontaneous closure can occur and a close observation can be an alternative to the early surgical treatment. Choroidal neovascularization can occur and treatment with anti‐VEGF therapy may help to maintain a stable anatomic and functional outcome for a long period.