Posterior scleritis after biweekly aflibercept intravitreal injections

To describe a case of posterior scleritis following anti-vascular endothelial growth factor (VEGF) injection.

A 51-year-old male receiving biweekly anti-VEGF injections for a central retinal vein occlusion complicated with cystoid macular edema presented with new-onset severe pain, photophobia, and tearing. Ophthalmological examination revealed choroidal folds and B-scan ultrasound confirmed significant thickening of the sclera, leading to a diagnosis of posterior scleritis. This resolved under topical and systemic corticosteroids.

Intravitreal anti-VEGF injections could be associated with non-infectious posterior scleritis. Clinicians should be particularly aware of this possibility in patients receiving frequent injections.