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. 2024 Dec 3;11(1):48.
doi: 10.1186/s40662-024-00416-y.

Bilateral occlusive retinal vasculitis secondary to intravitreal faricimab injection: a case report and review of literature

Yong Min Lee  1   2   3 , Rajya Gurung  4 , Jagjit Singh Gilhotra  4   5 , Sumu Simon  4 , Sudha Cugati  6   5
Affiliations

Bilateral occlusive retinal vasculitis secondary to intravitreal faricimab injection: a case report and review of literature

Yong Min Lee et al. Eye Vis (Lond). .

Abstract

Background: This article describes a rare occurrence of bilateral retinal occlusive vasculitis secondary to intravitreal faricimab injection.

Case presentation: A 72-year-old female with age-related macular degeneration presented with bilateral retinal occlusive vasculitis following intravitreal faricimab injections. The patient was treated with 3 days of intravenous methylprednisolone followed by oral prednisolone taper and topical steroid therapy. Resolution of retinal occlusive vasculitis was observed 2 months post treatment.

Conclusions: Retinal occlusive vasculitis is a rare complication of intravitreal anti-vascular endothelial growth factor (anti-VEGF), particularly with faricimab injections. We also present a review of literature regarding retinal occlusive vasculitis following intravitreal anti-VEGF injections and propose further information regarding its pathophysiology.

Keywords: Age-related macular degeneration; Faricimab; Intraocular inflammation; Intravitreal injection; Occlusive vasculitis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee(s) and with the Helsinki Declaration (as revised in 2013). Written informed consents were obtained from the parents for publication of this case report and accompanying images. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
FFA of the right and left eye on initial presentation with bilateral anterior uveitis. a Good arterial filling of the right eye with hyperfluorescent leakage in the macular region consistent with neovascular AMD; b Good arterial filling of the left eye with similar hyperfluorescent leakage in the macular region consistent with neovascular AMD. FFA, fundus fluorescein angiography; AMD, age-related macular degeneration
Fig. 2
Fig. 2
Fundus photo of both right and left eye on presentation 11 days following her bilateral intravitreal faricimab injections. a Fundus photo of the right eye showing peripapillary cotton wool spots with extensive arteritis and arteriolar whitening in the peripheries. There is perivascular haemorrhage along the superior arcade vessels; b Fundus photo of the left eye showing cotton wool spots along the inferior arcade vessels and perivascular whitening in the peripheries consistent with arteritis
Fig. 3
Fig. 3
FFA on presentation to emergency and 2 months following treatment with systemic steroid therapy. a FFA of the right eye 11 days following its second intravitreal faricimab injections showed delayed vascular filling consistent with occlusive vasculitis; b FFA of the left eye 11 days following its fourth intravitreal faricimab injections also showed delayed vascular filling consistent with occlusive vasculitis (right eye more severe than left eye); c FFA of the right eye at 2-month follow-up showed delayed but improved filling of the vessels and resolved perivascular leakage; d FFA of the left eye at 2-month follow-up showing similar resolved perivascular leakage. FFA, fundus fluorescein angiography
See this image and copyright information in PMC

References

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