ABSTRACT
PURPOSE: To describe characteristics of outer retinal tubulation (ORT) in eyes with subretinal neovascular membrane (SRNVM) associated with Macular Telangiectasia type 2 (MacTel type 2). METHODS: A retrospective analysis of longitudinal spectral domain optical coherence tomography (SD-OCT) scans of 46 eyes of 30 patients with SRNVM associated with MacTel type 2 was performed. To identify ORTs, each B-scan image of the macular cube (512 X 128) scan on the Cirrus® SD-OCT was reviewed. Changes in ORT characteristics, including location, size, reflectivity of the borders, and internal reflectivity, were noted during an average follow-up period of 18 months. RESULTS: Ten ORTs were detected in 7 of 46 eyes (15.2%); SRNVM showed no activity in six of these seven eyes. ORT was seen as round or ovoid hyporeflective spaces with hyperreflective borders, and measured 56 to 206 µm in height and 120 to 357 µm in width. An average of 1 bevacizumab injection (range: 0-2) was administered before at least one ORT was diagnosed. The mean interval between the last injection and detection of ORT was 10.2 months (range: 1-48 months). Over the 18-month follow-up period, ORTs were unchanged in four eyes, while in the remaining three eyes ORTs underwent structural changes. Five ORTs disappeared, four new ORTs appeared, and one ORT disappeared and reappeared. The size and the shape of ORT did not change, except in one case. CONCLUSION: Outer retinal tubulation can develop in eyes with MacTel type 2 associated SRNVM, with similar characteristics to ORT found in other degenerative diseases. ORTs may undergo dynamic structural modifications over time, with or without ongoing bevacizumab treatment.
Subject(s)
Retinal Neovascularization/pathology , Retinal Photoreceptor Cell Outer Segment/pathology , Telangiectasis/pathology , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
PURPOSE: 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). CONCLUSION: 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.
