Delayed-Onset Endophthalmitis after Intravitreal Aflibercept Injection

To describe delayed-onset infectious endophthalmitis 4 months after intravitreal aflibercept injection.

An 80-year-old female was referred with signs and symptoms of clinical endophthalmitis 4 months after intravitreal injection of aflibercept for choroidal neovascularization. Noninfectious causes of panuveitis were excluded and she was diagnosed with delayed-onset postinjection infectious endophthalmitis. Vitreous and aqueous specimens were prepared and antibiotics (vancomycin and ceftazidime) were injected intravitreally.

Vitreous culture was positive for Staphylococcus epidermidis. During the 1^st month after the antibiotic injections, symptoms and signs of the patient improved and became stable during the 6-month follow-ups.

Delayed-onset infectious endophthalmitis can be presented following intravitreal injections. Late presentation of uveitis in postinjected eyes needs complete investigations to rule out infectious endophthalmitis as an ophthalmic emergency.