Full-Thickness Macular Hole After Faricimab Treatment for Branch Retinal Vein Occlusion-Associated Macular Edema with Vitreomacular Traction: A Case Report
Abstract
Patient: Female, 72-year-old Final Diagnosis: Full-thickness macular hole following intravitreal faricimab injection for branch retinal vein occlusion-associated macular edema with vitreomacular traction Symptoms: Decreased visual acuity Clinical Procedure: — Specialty: Ophthalmology Objective: Unusual clinical course Background Branch retinal vein occlusion (BRVO) is a common cause of vision loss in older adults, and cystoid macular edema (CME) is its most frequent vision-threatening complication. Depending on severity, vitreomacular traction (VMT) is typically managed with observation or surgery. When CME develops during observation (e.g., in BRVO), the therapeutic approach becomes more complex. Anti-vascular endothelial growth factor (VEGF) therapy is a standard treatment for CME secondary to BRVO. Although full-thickness macular hole (FTMH) formation is rare, it has been reported in eyes with preexisting VMT, suggesting a contributory role for tractional forces. Case Report A 72-year-old woman under observation for VMT developed BRVO with CME. Baseline optical coherence tomography revealed VMT, an epiretinal membrane, a lamellar macular hole, and a vertical hyperreflective line at the fovea resembling the “foveal crack sign”. The patient received an intravitreal faricimab injection to achieve rapid edema resolution with fewer injections. CME improved; however, an FTMH subsequently developed, accompanied by a decline in best-corrected visual acuity to 20/33. The patient…
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