Iatrogenic choroidal neovascularization associated with subretinal gene therapy surgery

To report a case of iatrogenic choroidal neovascularization (CNV) developing one month after subretinal gene therapy surgery.

A 16-year-old male with biallelic RPE65 mutation associated retinal dystrophy was treated with subretinal voretigene neparvovec in the left eye. During initiation of a balanced salt solution pre-bleb, a faint and transient subretinal hemorrhage was observed at the retinotomy site. One month post-operatively, multi-modal imaging detected a CNV and a break in Bruch's membrane at the retinotomy site. The asymptomatic CNV was observed without treatment and resolved spontaneously.

As subretinal gene therapy surgery becomes more common, clinicians should monitor for possible trauma induced CNV associated with retinotomy formation and subretinal injection.