Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema following Central Retinal Vein Occlusion: 1 Initial Injection versus 3 Monthly Injections

Tractional retinal detachment is an uncommon complication of intravitreal anti-vascular endothelial growth factor (VEGF) injection wherein the drug triggers tractional retinal detachment as a result of fibrovascular membrane contraction. We present a case of a 42-year-old hypertensive woman diagnosed with chronic central retinal vein occlusion on both eyes. The right eye had total retinal detachment and neovascular glaucoma, while the left eye had retinal neovascularisation. Panretinal photocoagulation and intravitreal anti-VEGF injection was started on the left eye. However, she was lost to follow-up. She returned 4 months later with extensive tractional retinal detachment involving the macula on the left eye. She subsequently underwent vitrectomy with endolaser and silicone oil tamponade on the left eye. The anti-VEGF ‘crunch’ results from regression of fibrovascular proliferation with a concurrent increase in fibrosis, resulting in worsening retinal traction. With the widespread use of anti-VEGF agents, ophthalmologists need to be aware of this vision-threatening complication.

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One-year results of anti-vascular endothelial growth factor therapy combined with triamcinolone acetonide for macular edema associated with branch retinal vein occlusion

Japanese Journal of Ophthalmology ◽

10.1007/s10384-020-00765-w ◽

2020 ◽

Vol 64 (6) ◽

pp. 605-612

Author(s):

Rie Osaka ◽

Yuki Muraoka ◽

Yuki Nakano ◽

Yukari Takasago ◽

Yuta Koyama ◽

...

Keyword(s):

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Macular Edema ◽

Branch Retinal Vein Occlusion ◽

Vascular Endothelial ◽

Vein Occlusion ◽

Factor Therapy ◽

One Year ◽

Growth Factor Therapy ◽

Endothelial Growth Factor

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Cotton Wool Spots after Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema Associated with Central Retinal Vein Occlusion

Ophthalmologica ◽

10.1159/000443622 ◽

2016 ◽

Vol 235 (2) ◽

pp. 106-113 ◽

Cited By ~ 3

Author(s):

Teruyo Kida ◽

Akitaka Tsujikawa ◽

Yuki Muraoka ◽

Seiyo Harino ◽

Rie Osaka ◽

...

Keyword(s):

Vascular Endothelial Growth Factor ◽

Growth Factor ◽

Macular Edema ◽

Central Retinal Vein Occlusion ◽

Vascular Endothelial ◽

Cotton Wool ◽

Cotton Wool Spots ◽

Vein Occlusion ◽

Endothelial Growth Factor ◽

Central Retinal Vein

Purpose: To report a case series, whereby we encountered a transient increase in retinal cotton wool spots (CWS) following anti-vascular endothelial growth factor (anti-VEGF) therapy for the treatment of macular edema secondary to central retinal vein occlusion (CRVO). Methods: Eighteen eyes were treated with intravitreal aflibercept (IVA), and 5 were treated with intravitreal ranibizumab (IVR). Fundus photographs obtained 1 month after initial IVA or IVR injections were retrospectively evaluated for the presence of CWS. Results: Twenty-one (91.3%) patients had the following systemic diseases: hypertension, diabetes mellitus without retinopathy, dyslipidemia, or chronic renal failure requiring dialysis. One month after treatment, reduced macular edema was observed in 21 (91.3%) eyes. Initial injections facilitated complete resolution in 14 eyes, and CWS gradually became fainter with additional injections. Conclusion: Some eyes with CRVO-related macular edema can show a transient increase in CWS after initial anti-VEGF therapy; however, macular edema, retinal hemorrhage, and visual acuity were improved in almost every case.

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