• Int Ophthalmol · Apr 2018

    Case Reports

    Vitreous hemorrhage as an early sign of acute bacterial endophthalmitis following intravitreal ranibizumab injection.

    • Yishay Weill, Koby Brosh, Tamar Levi-Vineberg, and Joel Hanhart.
    • Department of Ophthalmology, Shaare Zedek Medical Center, Shmu'el Bait St 12, 9103102, Jerusalem, Israel. Yishayweill@gmail.com.
    • Int Ophthalmol. 2018 Apr 1; 38 (2): 799-802.

    PurposeTo report a case of acute bacterial endophthalmitis after antivascular endothelial growth factor injection with a rare presentation of vitreous hemorrhage.MethodsAn 84-year-old woman presented with sudden painless vision loss in her left eye, 3 days after intravitreal ranibizumab injection for cystoid macular edema due to neovascular age-related macular degeneration. The patient was otherwise asymptomatic. Dense vitreous hemorrhage was observed. At follow-up the next day, the patient complained on severe left eye pain. After examination, acute endophthalmitis was diagnosed.ResultsIntravitreal injection of vancomycin, ceftazidime and dexamethasone was performed. Vitreous and aqueous cultures grew Enterococcus faecalis. After treatment, the inflammation subsided but it took 3 months for the vitreous hemorrhage to totally resorb. Visual acuity was reduced to light perception.ConclusionsVitreous hemorrhage may be an atypical presentation of acute bacterial endophthalmitis occurring after intravitreal injection.

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