IATROGENIC POSTERIOR RETINAL BREAK FROM INTRAVITREAL ANTI-VEGF INJECTION IN A VITRECTOMIZED EYE.

PURPOSE: To describe a case of a perforating fluid stream of aflibercept resulting in an iatrogenic retinal break with possible subretinal infiltration using a prefilled syringe.

METHODS

History, examination, fundus photography, and Spectral Domain-Optical Coherence Tomography (SD-OCTs).

RESULTS

A 60-year-old woman with diabetic macular edema OU was treated with intravitreal aflibercept injections with a prefilled syringe. She developed a macular hole, which was repaired with vitrectomy surgery. She required ongoing intravitreal aflibercept injections after her macular hole surgery. Two days after an injection, the patient returned complaining of flashes, floaters, and a red linear streak in her vision. VA declined from 20/150 OS to 20/250. Examination showed an iatrogenic posterior retinal break with hemorrhage and edema. Fundus photography, fluorescein angiography, and OCT imaging were obtained. After 2 weeks of observation, the defect had closed. After 5 weeks, VA returned to 20/150 OS. She resumed intravitreal aflibercept injections using prefilled syringe.

CONCLUSION

This case presents a potential complication in vitrectomized patients receiving intravitreal injections.