Full-thickness macular hole after intravitreal injection of ranibizumab in a patient with retinal pigment epithelium detachment and tear

PURPOSE. To report a case of full-thickness macular hole (FTMH) after intravitreal injection of ranibizumab in a patient with retinal pigment epithelium detachment (PED) and tear. METHODS. A 67-year-old woman with PED and retinal pigment epithelium (RPE) tear due to age-related macular degeneration was studied by biomicroscopy, fluorescein and indocyanine green angiography, and optical coherence tomography and was treated with intravitreal ranibizumab. RESULTS. The patient developed a FTMH that was observed 1 month after the ranibizumab injection. CONCLUSIONS. Intravitreal ranibizumab may create focal sites of tractional forces on the retinal surface while contraction of the choroidal neovascular membrane may also place forces on the RPE and outer retina. Both actions may have as a result contraction and tearing of the retina leading to the formation of a FTMH. (Eur J Ophthalmol 2010; 20: 469-72)