Intravitreal bevacizumab for iatrogenic choroidal neovascular membrane following vitreoretinal surgery for retinal detachment

Abstract

We report the successful use of intravitreal bevacizumab in the iatrogenic choroidal neovascular membrane (CNVM) following vitreoretinal surgery. A 69-year-old male underwent vitrectomy surgery with silicone oil (SO) tamponade for rhegmatogenous retinal detachment. During fluid air exchange, there was an accidental retinal touch at an area in the papillomacular bundle with the silicone tip cannula. He had persistent subretinal bleed at the area 1 month after surgery. The optical coherence tomography (OCT) showed a subretinal elevated lesion and fluorescein angiography (FFA) showed an active CNVM. The patient was treated with intravitreal bevacizumab in the SO-filled eye. At 1-month postinjection, the OCT revealed reduction in the size of CNVM. The patient underwent SO removal with the second dose of intravitreal bevacizumab. CNVM regressed with no recurrence on follow-up at 1 year. Iatrogenic CNVM is a rare complication following successful vitreoretinal surgery. Prompt diagnosis and treatment with intravitreal bevacizumab may be required for a favorable outcome. Iatrogenic choroidal neovascular membrane (CNVM) is an uncommon condition usually associated with retinal laser or iatrogenic trauma during vitrectomy. Very few cases of iatrogenic CNVM have been reported in the literature, and the functional outcome has generally been poor in these reports despite treatment with laser photocoagulation, intravitreal bevacizumab, photodynamic therapy, and surgical removal of neovascular membranes. We report this case to highlight this rare complication following vitrectomy and its response to antivascular endothelial growth facor (VEGF) therapy.

Keywords

• avastin
• choroidal neovascular membrane
• intravitreal anti-vegf agents
• laser
• silicone oil
• vitrectomized eye