Partial spontaneous regression of the late-onset choroidal neovascularization after full-thickness macular hole surgery without anti-VEGF therapy: A case report

Introduction: The development of choroidal neovascularization (CNV) following macular surgery, including repair of full-thickness macular holes (FTMH), is a clinically significant but rare complication, particularly in patients with pre-existing retinal pigment epithelium (RPE)-Bruch’s membrane complex changes. Case presentation: We report a 71-year-old female patient who developed CNV in the right eye following surgical treatment for a FTMH. Regular monthly follow-up examinations allowed us to track the dynamics of the disease. Optical coherence tomography (OCT) and fluorescein angiography (FA) initially suggested stability. However, approximately 7 months post-surgery, a structural debut of exudative changes was observed. Anti-VEGF therapy was not administered to this eye, allowing for the observation of the natural course, which included progression followed by partial spontaneous regression. Conclusion: Our case highlights the importance of regular OCT monitoring after macular hole surgery in patients with AMD risk factors. While structural stability was maintained for months, the sudden debut of exudation and its subsequent wavelike fluctuation without treatment underscores the complex natural history of post-surgical CNV.