Aflibercept

An 89-year-old woman with bilateral neovascular age-related macular degeneration developed bilateral sterile intraocular inflammation following intravitreal aflibercept 8 mg injections [*route not stated*]. The woman experienced blurred vision and mild ocular pain in both eyes four days after receiving aflibercept 8 mg. History included prior sterile inflammation after aflibercept 2 mg. Examination revealed a marked anterior chamber reaction with Descemet's folds, 2+ vitreous cells and 3+ vitreous haze in both eyes. Intraocular pressures were normal. B-scan ultrasonography showed attached retinas with bilateral vitreous opacities. The initial differential included infectious endophthalmitis, but the bilateral presentation, quiet conjunctivae and her history supported a diagnosis of sterile intraocular inflammation. The woman was hospitalised and received intensive topical corticosteroids, antibiotics and cycloplegics. This led to rapid improvement and complete resolution of symptoms within four days, with recovery of baseline vision. …