Localised injection site inflammation following intravitreal anti-VEGF therapy

Author: Carl Mulholland (United Kingdom)

Co-authors: Kaleena Michael, Mohan Varikkara

Purpose

To report a case series of patients who developed localised ocular surface inflammation following intravitreal anti-VEGF injection. In addition, to characterise the clinical appearance of these reactions and how they can be appropriately managed.

Setting/Venue

The patients within this study attended the macular department at University Hospital Ayr for intravitreal anti-VEGF treatment of macular oedema.

Methods

A retrospective case review of patients presenting with similar injection site reactions following their intravitreal treatment. Patients within this study had received either Eylea (Aflibercept) or Lucentis (Ranibizumab). Assessment included slit lamp examination, clinical photographs and anterior segment OCT directly over inflamed area.

Results

The patients developed symptoms within a week following injection, were highly symptomatic and had some clinical similarities to localised anterior scleritis. All patients were reported to have resolution of symptoms following the use of topical steroid. The observed reaction appears to be unrelated to previous injections, site of injection or drug type.

Conlusions

This is an uncommon side-effect observed in patients undergoing intravitreal anti-VEGF. Early identification of injection site inflammation, and prompt distinction from more serious adverse events such as endophthalmitis is essential to ensure appropriate management.

Financial Disclosure

nil