Occlusive vasculitis due to hyperacute Streptococcus mitis endophthalmitis after intravitreal ranibizumab

Retinal Cases & Brief Reports
Kevin R BaxterAlan J Ruby

Abstract

To report a case of hyperacute Streptococcus mitis endophthalmitis after intravitreal ranibizumab resulting in occlusive vasculitis. Retrospective case report with ultra-wide-field color fundoscopic and fluorescein angiographic imaging. An 83-year-old woman received an intravitreal injection of ranibizumab to her right eye and was evaluated the next day (less than 24 hours from the injection) because of acute loss of vision. Her vision had decreased from 20/50 to hand motions in the right eye at the time of reevaluation. Wide-field fundus photography demonstrated pallid optic nerve head edema, generalized vascular attenuation, diffuse vascular sheathing, and scattered large postequatorial intraretinal hemorrhages. Ultra-wide-field fluorescein angiography revealed a severely delayed AV transit time associated with extensive areas of retinal nonperfusion and late retinal vascular leakage consistent with occlusive vasculitis. She underwent immediate pars plana vitrectomy with extensive irrigation of the vitreous cavity and intravitreal injection of antibiotics. In light of a worsening clinical course, she was taken for repeat vitrectomy 1 week later with panretinal endolaser photocoagulation, instillation of silicone oil, and sub-...Continue Reading

References

Mar 27, 2009·Ophthalmic Surgery, Lasers & Imaging : the Official Journal of the International Society for Imaging in the Eye·Eric ChenRichard S Kaiser
Jan 24, 2012·American Journal of Ophthalmology·Roger A GoldbergSerafin Gonzalez
Jan 15, 2014·American Journal of Ophthalmology·Ajay E KuriyanDarlene Miller

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Citations

Aug 21, 2020·Journal of Cataract and Refractive Surgery·Suman Pilli, Salem Murjaneh

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