Full-Thickness Macular Hole Formation After Intravitreal Faricimab Injection for Polypoidal Choroidal Vasculopathy

Fahsiri Tavonvunchai, Karntida Chanwimol Department of Ophthalmology, Mettapracharak (Wat Rai Khing) Hospital, Nakhon Pathom, ThailandCorrespondence: Fahsiri Tavonvunchai, Department of Ophthalmology, Mettapracharak (Wat Rai Khing) Hospital, 52 Moo 2 Rai Khing Sam Pran, Nakhon Pathom, 73210, Thailand, Email [email protected]: To report a case of an Asian man with idiopathic polypoidal choroidal vasculopathy (PCV) who developed a full-thickness macular hole (FTMH) following treatment with intravitreal faricimab, which resolved after vitreoretinal surgery.Patients and Methods: A 63-year-old man with idiopathic PCV was treated with intravitreal faricimab. Although pigment epithelial detachment (PED) decreased, he developed cystoid macular edema with vitreomacular traction (VMT), which progressed to a FTMH.Results: Pars plana vitrectomy and internal limiting membrane peeling successfully treated the FTMH. One year after the procedure, the macular hole remains closed, and the PCV was inactive.Conclusion: Various mechanisms may have contributed to the exacerbation of the preexisting VMT and PED, which finally resulted in the development of a FTMH. Careful attention should be paid to changes in the vitreomacular interface and posterior vitreous detachment before performing intravitreal anti-vascular endothelial growth factor treatment. Nevertheless, FTMHs can be successfully treated with prompt vitreoretinal surgery.Keywords: anti-vascular endothelial growth factor, pigment epithelial detachment, vitreomacular traction, vitreoretinal surgery