Tractional forces in epiretinal membrane (ERM) may antagonize the effects of anti-VEGF treatments and cause pharmacological resistance in patients with neovascular age related macular degeneration. Here we present a case with polypoidal choroidal vasculopathy (PCV) in conjunction with ERM who showed partial response to intravitreal aflibercept injections. He underwent pars plana vitrectomy with ERM peeling. After surgery, optical coherence tomography showed an improvement in macular morphology and complete resolution of subretinal fluid. His visual acuity remained stable after surgery. Vitrectomy may be beneficial to improve anti vascular epithelial growth factor (anti-VEGF) response in some of the patients with ERM who do not respond to anti-VEGF therapy for PCV.
Keywords: polypoidal choroidal vasculopathy, epiretinal membrane, aflibercept