Long-Term Outcomes following Intravitreal Ranibizumab for Choroidal Neovascularization Related to Nd:YAG Laser Macular Injury: A Case Report

Abstract

Choroidal neovascularization (CNV) secondary to Nd:YAG laser macular injury consists of a rare condition without standardized treatment. Herein, we present the long-term outcomes of a case with a spontaneous closure of a laser-associated macular hole that was followed by late-onset CNV and was successfully treated with intravitreal ranibizumab. A 32-year-old man suffered a macula injury in his right eye after accidental exposure to an 800-nm wave length Nd:YAG laser pulse. Ophthalmological examination demonstrated deterioration in visual acuity along with parafoveal and post-hyaloid hemorrhage. After 1 month, fundoscopy indicated the formation of a full-thickness macular hole. A close observation revealed spontaneous closure of the hole and visual improvement within the next month. One and a half year later, the patient presented with sudden visual distortion, while optical coherence tomography and fluorescein angiography disclosed the development of CNV. The patient was successfully treated with a single intravitreal injection of ranibizumab. The patient’s condition has remained stable during an 8-year follow-up period. In conclusion, laser-induced macular injury consists of an increasingly remarkable condition that may have a profound impact on visual outcomes. Our case provides insight into the potential mechanisms of Nd:YAG laser injury and its complications, indicating that CNV may occur even in the long term, while anti-vascular endothelial growth factor may help maintain stable anatomic and functional outcomes.

© 2023 The Author(s). Published by S. Karger AG, Basel

References Thach AB, Lopez PF, Snady-McCoy LC, Golub BM, Frambach DA. Accidental Nd:YAG laser injuries to the macula. Am J Ophthalmol. 1995;119(6):767–73. Scollo P, Herath G, Lobo A. Retinal injury by industrial laser burn. Occup Med2014;64(3):220–2. Barkana Y, Belkin M. Laser eye injuries. Surv Ophthalmol. 2000;44(6):459–78. Ying HS, Symons RCA, Lin KL, Solomon SD, Gehlbach PL. Accidental Nd:YAG laser-induced choroidal neovascularization. Lasers Surg Med. 2008 Apr;40(4):240–2. Combillet F, Saunier V, Rougier MB, Delyfer MN, Korobelnik JF. Multimodal imaging in a case of self-inflicted laser-induced maculopathy. Eur J Ophthalmol. 2016 Nov 4;26(6):e155–e157. Fernandez MP, Modi YS, John VJ, Berrocal AM. Accidental Nd:YAG laser-induced macular hole in a pediatric patient. Ophthalmic Surg Lasers Imaging Retina. 2013;44 Online(6):e7–10. Potthofer S, Foerster MH. Vitrectomy and autologous thrombocyte adhesion of an accidental macular hole caused by Nd:YAG laser. Br J Ophthalmol. 1997;81(9):803–4. Tran K, Wang D, Scharf J, Sadda S, Sarraf D. Inner choroidal ischaemia and CNV due to handheld laser-induced maculopathy: a case report and review. Eye2020 Nov;34(11):1958–65. Nehemy M, Torqueti-Costa L, Magalhães EP, Vasconcelos-Santos DV, Vasconcelos AJ. Choroidal neovascularization after accidental macular damage by laser. Clin Exp Ophthalmol. 2005 Jun;33(3):298–300. Liang F, Puche N, Soubrane G, Souied EH. Intravitreal ranibizumab for choroidal neovascularization related to traumatic Bruch’s membrane rupture. Graefes Arch Clin Exp Ophthalmol. 2009 Sep;247(9):1285–8. Author Contacts

Evita Evangelia Christou, evitachristou@gmail.com

Article / Publication Details

Received: October 27, 2022
Accepted: January 15, 2023
Published online: February 17, 2023
Issue release date: January – December

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0


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1663-2699 (Online)

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