to report 2 eyes of a patient which developed vitreomacular traction ( vmt ) 1 month after intravitreal bevacizumab ( ivb ) injection . a 45-year - old female with bilateral diffuse diabetic macular edema ( dme ) received bilateral ivb . her initial visual acuity ( va ) was 0.15 and 0.2 in od and os , respectively . central foveal thickness ( cft ) was 568 and 662 m in od and os , respectively , without any sign of vmt . one month after ivta injection , vmt was released and cft decreased to 163 and 181 m in od and os , respectively . six months after ivta injection , cft was 163 and 153 m , and va was 0.7 and 0.9 in od and os , respectively . in eyes with dme and attached posterior vitreous , vmt may develop after ivb injection and increase edema . diabetic macular edema ( dme ) is the most common cause of moderate vision loss in patients with diabetic retinopathy . vascular endothelial growth factor ( vegf ) has been shown to increase retinal vessel permeability and is a critical stimulus for dme . intravitreal injection of bevacizumab , a monoclonal antibody which targets vegf , has been shown to provide stability or improvement in eyes with dme . ocular adverse effects of intravitreal bevacizumab ( ivb ) include bacterial endophthalmitis , tractional retinal detachment , uveitis , rhegmatogenous retinal detachment , and vitreous hemorrhage . we report 2 eyes of a patient which developed vitreomacular traction ( vmt ) and increased dme after ivb injection . a 45-year - old female with type 2 diabetes had a visual acuity ( va ) of 0.15 od and 0.2 os . there was leakage from capillaries and microaneurysms in the perifoveal area and findings of mild proliferative diabetic retinopathy ( pdr ) on fundus fluorescein angiography examination . central foveal thickness ( cft ) , as revealed by optical coherence tomography ( oct ) ( rtvue ; optovue inc . , fremont , calif . , usa ) , was 568 and 662 m in od and os , respectively ( fig . both eyes received ivb injection ( 1.25 mg/0.05 ml ) at a 1-week interval . at week 1 , va improved to 0.2 and 0.5 , and cft decreased to 252 and 436 m in od and os , respectively . one month after ivb injection , va decreased to 0.1 and 0.2 , and cft increased to 559 and 724 m in od and os , respectively , due to vmt , as revealed by oct ( fig . this time , intravitreal triamcinolone ( ivta , 4 mg/0.1 ml ) injection was performed on both eyes . the patient 's va improved to 0.2 and 0.3 , and cft decreased to 284 and 173 m in od and os , respectively , 1 week after ivta injection . one month after ivta injection , vmt was released , as revealed by oct , and cft was 163 and 181 m , and va was 0.5 and 0.8 in od and os , respectively ( fig . six months after ivta , cft was 163 and 153 m , and va was 0.7 and 0.9 in od and os , respectively ( fig . safety studies have reported the ocular side effects of ivb injection as endophthalmitis , tractional or rhegmatogenous retinal detachment , traumatic injury to the lens , retinal pigment epithelial tears , subretinal bleeding , uveitis , elevated intraocular pressure , retinal artery occlusion , and acute visual loss without apparent reason [ 3 , 5 , 6 ] . arevalo et al .   reported 11 eyes with severe pdr which developed or had progression of tractional retinal detachment after ivb injection . .   reported that 1 eye developed vmt out of 20 eyes which had received intravitreal injection of ranibizumab for central retinal vein occlusion . they attributed this to the pathology itself not to the ranibizumab injection . in the present study , we presented 2 eyes of a patient who had ivb injection for dme which responded well initially but developed vmt at 1 month . the traction developed only at the macula , and other parts of the posterior vitreous were detached . this traction caused massive cystoid macular edema worse than that which had existed prior to injection in both eyes . first , ivb injection might have induced posterior vitreous detachment while firm adhesions at the fovea did not release , thus increasing the macular edema . second , ivb injection might have increased anteroposterior forces by causing contraction of the vitreous and posterior hyaloid face , increasing the macular edema beyond that of the preinjection state . after ivta injection , the vmt released and the macular edema resolved in both eyes and remained stable for 6 months of follow - up without any additional intervention . this may support the hypothesis that the posterior vitreous played a role in the etiology of the macular edema prior to ivb injection , and formation of the vmt worsened the edema . the possible mechanism which played a role in the release of vmt after ivta injection was probably mechanical forces . in conclusion , in eyes with dme and attached posterior vitreous , vmt may develop after ivb injection and increase edema .
purposeto report 2 eyes of a patient which developed vitreomacular traction ( vmt ) 1 month after intravitreal bevacizumab ( ivb ) injection.materials and methodsa 45-year - old female with bilateral diffuse diabetic macular edema ( dme ) received bilateral ivb.resultsher initial visual acuity ( va ) was 0.15 and 0.2 in od and os , respectively . 
 central foveal thickness ( cft ) was 568 and 662 m in od and os , respectively , without any sign of vmt . 
 both eyes responded well initially but developed vmt at 1 month . 
 this time , intravitreal triamcinolone ( ivta ) injection was performed . 
 one month after ivta injection , vmt was released and cft decreased to 163 and 181 m in od and os , respectively . 
 six months after ivta injection , cft was 163 and 153 m , and va was 0.7 and 0.9 in od and os , respectively.conclusionin eyes with dme and attached posterior vitreous , vmt may develop after ivb injection and increase edema . 
 ivta injection might be an option to release vmt before considering vitrectomy .