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עמוד בית
Mon, 29.04.24

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December 2015
Ori Segal MD, Joseph R. Ferencz MD, Michael Mimouni MD, Ronit Nesher MD, Perri Cohen MA and Arie Y. Nemet MD
 

Background: Reports of lamellar macular holes (LMHs) with underlying age-related macular degeneration (AMD) are rare and the specific definition, pathogenesis, and surgical recommendations for this macular condition remain unclear.


Objectives: To present a series of LMHs in eyes with underlying end-stage AMD, and describe optical coherence tomography (OCT) detection of associated morphologic abnormalities.


Methods: We reviewed the files of consecutive patients diagnosed with LMH and underlying end-stage AMD between September 2007 and September 2011. 


Results: Sixteen eyes of 14 patients were included in this study. The average follow-up after the OCT-established diagnosis of LMH was 19.8 months (range 4–48). The average visual acuity (VA) at last follow-up visit was 20/400 (20/60–20/1200). The best-corrected VA was stable in 10 eyes (62.5%) and deteriorated in 6 (37.5%). There was a statistically significant correlation between VA and minimal foveal thickness (r = -0.598, P = 0.014).


Conclusions: In this series of LMHs with underlying AMD the OCT findings were intraretinal fluid, cystic spaces and window defect.


 
July 2013
O. Segal, J.R. Ferencz, P. Cohen, .A.Y. Nemet and R. Nesher

Background: The number of patients treated with intravitreal injections has increased significantly over the past few years, mainly following the introduction of anti-vascular endothelial growth factor antibody intraocular medications. Bevacizumab is mostly used in this group of medications.

Objectives: To describe persistent elevation of intraocular pressure (IOP) following intravitreal injection of bevacizumab.

Methods: We reviewed consecutive cases of persistent IOP elevation after intravitreal bevacizumab injection for exudative age-related macular degeneration (AMD). A total of 424 patients (528 eyes) met the inclusion criteria and received 1796 intravitreal injections of bevacizumab. Persistent IOP elevation was found in 19 eyes (3.6%, 19/528) of 18 patients (4.2%, 18/424) with IOP elevated 30–70 mmHg, 3–30 days after injection.

Results: Mean IOP was 42.6 mmHg (range 30–70); IOP elevations occurred after an average of 7.8 injections of bevacizumab (range 3–13). Injected eyes (19/528) had a significantly higher incidence of elevated IOP than uninjected eyes (fellow eyes), 1/328, P < 0.001.

 Conclusions: Like other anti-vascular endothelial growth factor (VEGF) substances reported in a few recent studies, intravitreal injection of bevacizumab for neovascular AMD may be associated with persistent IOP elevation. Providers should be aware that significant IOP elevation might occur after repeated treatments. 

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