Lamellar macular hole following intravitreal aflibercept injection in a patient with neovascular age-related macular degeneration

Purpose: To report a case where a lamellar macular hole (LMH) developed following intravitreal injection of aflibercept due to neovascular age-related macular degeneration (nAMD). Material and Methods: A 70-year-old man diagnosed with nAMD underwent intravitreal aflibercept injections for three consecutive months. At follow up, the resolution of the subretinal fluid was revealed by optical coherence tomography (OCT), and a visual improvement was observed. One month later, visual impairment occurred with respect to the activation of the neovascular membrane. Hence, intravitreal injection of aflibercept was performed again. Results: The LMH developed after one month following the last injection, as demonstrated by OCT, in addition to the resolution of subretinal fluid and some visual improvement. Conclusion: To our knowledge, this is the first case study reporting such LMH formation after intravitreal aflibercept injection. The literature was evaluated for mechanisms in explaining the formation of LMH after aflibercept injection.