First Author: H.B.Arifoglu TURKEY
Co Author(s): B. Alabay A.S. Karatepe Hashas Y. Yuce G. Kızılcay T. Ersekerci M. Atas 0 0 0 0 0 0 0 0 0
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To report the development of a full thickness macular hole (FTMH) after treatment with a single intravitreal injection of ranibizumab in a patient with diabetic cystoid macular edema.
A 67-year-old woman with type 2 diabetes mellitus who had panretinal photocoagulation for proliferative diabetic retinopathy presented at our department for decreased vision in her right eye (RE). On examination, best corrected visual acuity (BCVA) was 20/400 in the RE. Anterior segment examination was unremarkable and funduscopy of the RE revealed cystoid macular edema (CME). There was no posterior vitreous detachment (PVD) or clinically detectable vitreomacular traction (VMT). Optical coherence tomography confirmed the presence of cystoid DME without vitreomacular traction. Intravitreal 0.5 mg ranibizumab injection was administered without complication.
1 month after the injection of ranibizumab patient complained of newly developed metamorphopsia. BCVA deteriorated to 6/200 and slip-lamp biomicroscopy revealed a FTMH with no PVD or VMT. OCT confirmed the presence of a FTHM and no evidence of any areas of partial vitreous separation associated with vitreoretinal adhesions or areas of vitreous traction in any OCT scan.
Full thickness macular hole; a rare adverse effect of ranibizumab injection, should be included in the differential diagnosis of post-injectional visual loss in patients with diabetic CME.