Intraretinal neovascularization coexisting with an idiopathic epiretinal membrane: Long-term stability after anti-VEGF monotherapy – A case report

A 50-year-old man presented with metamorphopsia and decreased vision (20/40) in the right eye. Fundoscopy showed a presumed idiopathic epiretinal membrane (ERM) with vascular tortuosity. Optical coherence tomography (OCT) revealed inner retinal distortion with cystoid changes, and OCT angiography detected a dense, irregular intraretinal neovascular (IRNV) network in the superficial plexus, with late fluorescein leakage. After three intravitreal bevacizumab injections over 6 months, vision improved to 20/20 with regression of neovascularization and resolution of cystoid changes. Over 9 years, vision and imaging remained stable without further therapy, underscoring OCT angiography’s role in identifying occult IRNV and the long-term efficacy of anti-VEGF in vascularized ERMs.