Hemolytic Glaucoma Following Intravitreal Aflibercept Injection for Age-Related Macular Degeneration: A Case Report

Area of Science:

• Ophthalmology
• Retina
• Vitreoretinal Surgery

Background:

• Intraocular pressure (IOP) elevation post-intravitreal anti-VEGF injection for AMD is rare.
• While hyphema is reported, secondary glaucoma from hemolysis or ghost cells is undocumented.
• This case highlights a rare complication of anti-VEGF therapy.

Purpose of the Study:

• To report a case of hemolytic glaucoma secondary to intraocular hemorrhage after intravitreal anti-VEGF injection.
• To emphasize the importance of recognizing and managing this rare complication.
• To discuss the surgical outcomes for this condition.

Main Methods:

• A case report of a 54-year-old male with exudative AMD.
• Intravitreal aflibercept injections were administered for 1 year.
• Patient developed acute IOP elevation and hyphema after the tenth injection.
• Surgical intervention included anterior chamber irrigation and pars plana vitrectomy.

Main Results:

• The patient presented with decreased vision and significantly elevated IOP (50 mmHg).
• Slit-lamp examination revealed hyphema with a fluid level.
• Surgery revealed vitreous hemorrhage and a blood clot at the injection site.
• Postoperatively, IOP normalized, with no recurrence during 1-year follow-up.

Conclusions:

• Hemolytic glaucoma is a rare but possible complication after intravitreal anti-VEGF injections in AMD patients.
• Vigilance for post-injection IOP elevation is crucial for clinicians.
• Timely surgical intervention can lead to favorable visual and IOP outcomes.