Incomplete posterior hyaloid detachment after intravitreal pegaptanib injection in diabetic macular edema

PURPOSE. Posterior hyaloid adherences play a role in the pathogenesis of diabetic macular edema (DME). Intravitreal antivascular endothelial growth factor (VEGF) drugs are presently being used to treat DME. The authors report one case of incomplete posterior hyaloid detachment (PHD) following intravitreal pegaptanib to treat DME. This case shows a combined mechanism of DME resolution by anti VEGF and PHD. METHODS. Prospective, interventional, single case report. One male patient with bilateral DME was treated by intravitreal pegaptanib in his right eye every 6 weeks for 6 months (five injections) and followed for 42 months. RESULTS. Central macular thickness decreased from 511 to 376 mu m at month 4 in the treated eye and remained within 10% of this value during follow-up. The posterior hyaloid became taut and partially detached after the third injection and was almost completely detached 1 year later. Visual acuity remained unchanged in both eyes during follow-up. CONCLUSIONS. PHD may play an important role in cases where macular thickness is successfully reduced or better acuity is achieved after intravitreal injections.