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Updated: Oct 4, 2025

Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
Simultaneous development of full-thickness macular hole and neovascular age-related macular degeneration
Shuichiro Aoki1, Hiroko Imaizumi1
1Sapporo City General Hospital, Sapporo, Japan.
Purpose:
To present a case of full-thickness macular hole (MH) with treatment-naïve neovascular age-related macular degeneration (nAMD).
Observations:
A 74-year-old woman presented with sudden visual impairment and floaters in her left eye. Fundus examination revealed retinal hemorrhages and hemorrhagic pigment epithelial detachment at the fovea. Optical coherence tomography angiography revealed both type 1 nAMD and stage 4 MH obscured by blood. After the first intravitreal aflibercept injection, early pars plana vitrectomy in addition to the inverted internal limiting membrane flap technique was performed to close MH without complications. This improved the patient's visual acuity. Throughout the postoperative follow-up period of 18 months, recurrent exudates from nAMD required repetitive aflibercept injections; MH relapse was not observed.
Conclusions:
MH can be complicated by acute, treatment-naïve nAMD. Early surgical closure of secondary MH combined with anti-vascular endothelial growth factor therapy for nAMD may yield a satisfactory visual outcome.
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