Early Miscarriage Occurring Six Days After Intravitreal Ranibizumab Injection

The aim of this case report was to describe a miscarriage which occurred 6 days after an intravitreal Ranibizumab (IVR) injection. A 24-year-old female patient with type 1 diabetes diagnosed with diabetic macular edema in her left eye planned for 3 injections of IVR at one-month intervals. She had been receiving insulin injections 3 times a day and her Hemoglobin A1C (HbA1c) was in the approximate range of 6-7%. An ophthalmologic examination revealed that the patient's Snellen corrected distance visual acuity (CDVA) was 10/10 in her right eye and 3/10 in her left eye. The patient was unaware of her pregnancy at the time of initial injection. Two days after the first injection, she found out that she was 5 weeks pregnant. This was the first pregnancy for the patient and there were no risk factors for miscarriage rather than diabetes. Six days after the injection, she was admitted to the hospital due to severe abdominal pain and vaginal bleeding. Miscarriage was diagnosed and she underwent curettage procedure. We concluded that pregnancy tests should be administered prior to intravitreal injection for female patients of reproductive age, and patient testimony should not be the sole reason to dismiss the possibility of pregnancy.