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Endophthalmitis in Retinopathy of Prematurity after Intravitreal Aflibercept Injection
Elcin Suren1, Ersan Cetinkaya1, Mustafa Kalayci1
1University of Health Sciences, Antalya Training and Research Hospital, Department of Ophthalmology, Antalya, Turkey.
Insights
A male infant treated for retinopathy of prematurity with an intravitreal anti-VEGF injection developed a severe retinal lesion. Pars plana vitrectomy was required due to the lack of improvement with endophthalmitis treatment.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Retinal Diseases
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Intravitreal anti-VEGF agents are increasingly used for ROP treatment.
- Complications following anti-VEGF injections in neonates require careful monitoring.
Observation:
- A male infant received an intravitreal aflibercept injection for ROP at 35-week postmenstrual age.
- Four days post-injection, retinal imaging revealed a yellowish-gray mass and vitreous blurring in the right eye.
Findings:
- Despite initiating endophthalmitis treatment, the retinal lesion showed no improvement after two days.
- Worsening clinical signs necessitated a 25-gauge lens-sparing pars plana vitrectomy.
Implications:
- This case highlights a potential severe inflammatory complication following intravitreal anti-VEGF injections in infants.
- Early recognition and surgical intervention may be crucial for managing such sight-threatening conditions in neonates.
Abstract:
We report the case of a male infant who had an intravitreal anti-VEGF (aflibercept) injection for the treatment of retinopathy of prematurity at 35-week postmenstrual age. Four days following the injection, retinal imaging demonstrated a yellowish gray blurred mass that extended into the vitreous in the right eye, and the vitreous body was blurred. After two days, despite starting endophthalmitis treatment, there was still no improvement in the retinal lesion. Due to the worsening of the clinical signs, we decided to perform 25-gauge lens-sparing pars plana vitrectomy.
