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KMID : 0360220210620040577
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Journal of the Korean Ophthalmological Society
2021 Volume.62 No. 4 p.577 ~ p.582
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Angle-closure Attack after Retinal Pigment Epithelium Double-tear and Hemorrhagic Retinal Detachment in Exudative Macular Degeneration
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Choi Yu-Jin
Choi Young-Je
Cho Yong-Wun
Kim Byoung-Seon
Yoo Woong-Sun
Chung In-Young
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Abstract
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Purpose: To report a case of acute angle-closure attack resulting from hemorrhagic retinal detachment after a double retinal pigmentepithelium (RPE) tear in exudative age-related macular degeneration (AMD) with large pigment epithelial detachment(PED).
Case summary: A 66-year-old female visited with a complaint of poor vision in left eye, which began 1 month prior. She was diagnosedwith exudative AMD with a large PED using optical coherence tomography and indocyanine green angiography.
Intravitreal aflibercept injection was performed. The RPE tear occurred at 2 weeks after the intravitreal anti-vascular endothelialgrowth factor injection for AMD, after which the range of the RPE tear expanded and included the macular area at 4 weeks afterthe second injection. At 3 months after the third injection, massive submacular hemorrhage occurred; aflibercept injection wasrepeated. At 3 days after the fourth injection, the patient’s intraocular pressure (IOP) was 60 mmHg, and massive hemorrhagicserous retinal detachment and anterior movement of the lens with total angle closure were observed. Therefore, we performeda sclerotomy; a large amount of dark blood and subretinal fluid was drained. The IOP decreased, and the retinal detachment improvedsomewhat. The patient was kept under observation for careful monitoring of her condition.
Conclusions: It is very rare to experience a double RPE rupture after intravitreal anti-vascular endothelial growth factor injectionin AMD. We report on our experience and treatment of acute angle-closure attack. The IOP increased due to hemorrhagic retinaldetachment after a double RPE tear over the treatment course.
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KEYWORD
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Exudative macular degeneration, Retinal detachment, Retinal pigment epithelial detachment
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