Sisk Robert A
Cincinnati Eye Institute, 9997 Carver Rd, Blue Ash, OH 45242, United States.
University of Cincinnati Medical Center, Department of Ophthalmology, 231 Albert Sabin Way, Cincinnati, OH 45267, United States.
Retin Cases Brief Rep. 2025 Apr 2. doi: 10.1097/ICB.0000000000001757.
To describe a case of occlusive retinal vasculitis (ORV) following intravitreal aflibercept 8mg injection for wet macular degeneration.
Retrospective, interventional case report.
A 72-year-old female presented with classic ORV 11 days after intravitreal aflibercept 8mg injection in her left eye for wet macular degeneration. Visual acuity (VA) declined from 20/30 to 20/400. Laboratory investigations including Gram stain and cultures of vitreous aspirate, studies for infectious and non-infectious uveitis and hypercoagulable state were all negative. Oral prednisone, sub-Tenon's triamcinolone acetonide (STTA), intravitreal dexamethasone and antibiotic injections, and topical steroids resulted in visual and anatomic improvement. ORV recurred when prednisone was tapered to 10mg/day and was controlled with additional STTA, oral solumedrol, and a 0.18mg fluocinolone acetonide implant. Subsequently exudation from wet macular degeneration recurred and responded to intravitreal faricimab with recovery to 20/30.
ORV is a rare complication of some intravitreal anti-VEGF medications and infectious causes of endophthalmitis. It can be managed with aggressive steroid treatment for an excellent visual outcome in some cases, although the disease may be chronic or recurrent.
描述1例玻璃体腔注射8mg阿柏西普治疗湿性黄斑变性后发生的闭塞性视网膜血管炎（ORV）病例。
回顾性干预性病例报告。
一名72岁女性在左眼玻璃体腔注射8mg阿柏西普治疗湿性黄斑变性11天后出现典型的ORV。视力（VA）从20/30下降至20/400。包括玻璃体抽吸物革兰氏染色和培养、感染性和非感染性葡萄膜炎及高凝状态检查在内的实验室检查均为阴性。口服泼尼松、球周注射曲安奈德、玻璃体腔注射地塞米松和抗生素以及局部使用类固醇后，视力和解剖结构均有改善。当泼尼松减至10mg/天时，ORV复发，通过额外的球周注射曲安奈德、口服甲泼尼龙和植入0.18mg氟轻松醋酸酯得以控制。随后湿性黄斑变性渗出复发，玻璃体腔注射法西单抗后视力恢复至20/30。
ORV是某些玻璃体腔抗VEGF药物和眼内炎感染原因的罕见并发症。在某些情况下，通过积极的类固醇治疗可取得良好的视力预后，尽管该病可能为慢性或复发性。
