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Abstract

Purpose

Posterior hyaloid adherences play a role in the pathogenesis of diabetic macular edema (DME). Intravitreal antivascular endothelial growth factor (VEGF) drugs are presently being used to treat DME. The authors report one case of incomplete posterior hyaloid detachment (PHD) following intravitreal pegaptanib to treat DME. This case shows a combined mechanism of DME resolution by anti VEGF and PHD.

Methods

Prospective, interventional, single case report. One male patient with bilateral DME was treated by intravitreal pegaptanib in his right eye every 6 weeks for 6 months (five injections) and followed for 42 months.

Results

Central macular thickness decreased from 511 to 376 μm at month 4 in the treated eye and remained within 10% of this value during follow-up. The posterior hyaloid became taut and partially detached after the third injection and was almost completely detached 1 year later. Visual acuity remained unchanged in both eyes during follow-up.

Conclusions

PHD may play an important role in cases where macular thickness is successfully reduced or better acuity is achieved after intravitreal injections.

Keywords

Diabetic macular edema Pegaptanib Posterior hyaloid detachment

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References

Aiello

L.P.

, Bursell

S.E.

, Clermont

Vascular endothelial growth factor-induced retinal permeability is mediated by protein kinase C in vivo and suppressed by an orally effective beta-isoform-selective inhibitor. Diabetes 1997; 46: 1473–80.

Cunningham

E.T.

Jr. , Adamis

A.P.

, Altaweel

A phase II randomized double-masked trial of pegaptanib, an anti-vascular endothelial growth factor aptamer, for diabetic macular edema. Ophthalmology 2005; 112: 1747–57.

Avery

R.L.

, Pearlman

, Pieramici

D.J.

Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology 2006; 113: 1695e1–15.

Arevalo

J.F.

, Fromow-Guerra

, Quiroz-Mercado

Primary intravitreal bevacizumab (Avastin) for diabetic macular edema: results from the Pan-American Collaborative Retina Study Group at 6-month follow-up. Ophthalmology 2007; 114: 743–50.

Lazic

, Gabric

Intravitreally administered bevacizumab (Avastin) in minimally classic and occult choroidal neovascularization secondary to age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2007; 245: 68–73.