Treatment of AMD-related macular neovascularization in a patient with silicone oil tamponade

Abstract

Purpose: to present a case of active neovascular AMD treated with anti-VEGF drug in the presence of silicone oil. Study design: case report. Results: A 69-year-old male was referred to the surgical retina service due to a sudden loss of peripheral vision in the left eye (LE). Biomicroscopic examination revealed the presence of geographic atrophy in the right eye (RE) and a macula-on retinal detachment in the far periphery with drusen at the posterior pole in LE. Combined OCT-OCTA examination demonstrated the presence of non-active type 1 MNV in the LE. The patient underwent a 25-gauge pars plana vitrectomy (PPV) with silicone oil tamponade in the LE. Post-operative follow-up involved clinical and instrumental monitoring every 7 days for the first 3 months and every 15 days in the fourth month, until the removal of the silicone oil. During the follow-up, we detected the reactivation of type 1 MNV in the LE, and as a result, the patient received three monthly Ranibizumab injections in the LE, in conjunction with the removal of silicone oil from the vitreous cavity at the at the fourth month postoperatively. Conclusions: our case report highlights the clinical response to three injections of intravitreal Ranibizumab therapy in managing active neovascular AMD with SO tamponade. The duration of intravitreal Ranibizumab therapy in SO may not differ significantly compared to an eye with intact vitreous humor.