Visual loss from hyphema following intravitreal bevacizumab

Abstract

Intravitreal injections are the most common ocular procedures in an ophthalmic practice. Despite their safety profiles, complications can happen such as visually threatening intraocular bleeding. We present a case of a 32-year-old woman with idiopathic retinal vasculitis (Eales' disease), rubeosis iridis, and visual loss in the left eye from cystoid macular oedema. The patient had prior vitrectomy and multiple subtenon injections of corticosteroids. She underwent injection of intravitreal bevacizumab. The patient rubbed her eyes and developed subtotal hyphema. She also subsequently developed a panic attack. The bleeding spontaneously resolved over several hours. In eyes needing intraocular injections, caution needs to be taken in patients with rubeosis iridis who have had prior vitrectomy and subtenon injections of corticosteroids, and they need to be instructed to avoid ocular rubbing.

A Review of Eales’ Disease and Mycobacterium tuberculosis

“…A rare case involved a patient with recurrent vitreous hemorrhage unresponsive to intravitreal anti-VEGF therapy, who was effectively treated with a combined therapy of photocoagulation and anti-VEGF therapy of ischemic retinal areas, resulting in improved visual acuity without signs of recurrence [ 36 , 37 , 38 ]. Anti-VEGF therapy is globally recognized as a safe and widely utilized treatment for retinal diseases without any severe drug-related ocular events [ 39 , 40 , 41 ]. This treatment in the early stage of Eales’ Disease seems to reduce the necessity of vitrectomy and helps recovering patients with Eales’ Disease with visual loss from hyphemia [ 39 ].…”

“…Anti-VEGF therapy is globally recognized as a safe and widely utilized treatment for retinal diseases without any severe drug-related ocular events [ 39 , 40 , 41 ]. This treatment in the early stage of Eales’ Disease seems to reduce the necessity of vitrectomy and helps recovering patients with Eales’ Disease with visual loss from hyphemia [ 39 ]. However, anti-VEGF therapy for various retinal diseases could cause ocular hypertension (OHT) after the injection.…”