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Post-Ranibizumab injection endophthalmitis in aggressive posterior retinopathy of prematurity
Parijat Chandra1, Devesh Kumawat1, Ruchir Tewari1
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Insights
A preterm infant with aggressive retinopathy of prematurity developed endophthalmitis after ranibizumab injection. Prompt treatment with antibiotics and steroids, followed by vitrectomy, successfully saved the infant's eye.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Infectious Diseases
Background:
- Aggressive posterior retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Intravitreal injections, while effective for ROP, carry a risk of infectious complications like endophthalmitis.
- This case highlights a rare but severe complication following ranibizumab treatment for ROP.
Abstract:
A preterm infant with zone 1 aggressive posterior retinopathy of prematurity developed infectious endophthalmitis after intravitreal injection of ranibizumab. Urgent empirical intravitreal therapy with vancomycin, ceftazidime, and dexamethasone along with intravenous therapy with amikacin and meropenem helped in early resolution. Vascularization/activity of disease subsided on follow-up, media cleared, and laser photocoagulation was completed. Later the disease reactivated, developed vitreous membranes and central retinal traction, for which 25-gauge lens-sparing vitrectomy was performed. Emergent treatment helped in salvaging the eye from both aggressive ROP disease and devastating endophthalmitis. Rationale approach to such a case is being discussed.
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