Episcleritis following intravitreal ranibizumab injection for exudative age‐related macular degeneration

Abstract Purpose Ranibizumab is a recombinant, humanized, monoclonal antibody antigen‐binding fragment that neutralizes all biologically active forms of vascular endothelial growth factor (VEGF), and is effectively used in the treatment of neovascular age‐related macular degeneration (AMD). Ocular and systemic side effects may be encountered after its intravitreal injection. We report the importance of provide information for patients about the alarm signs and when to seek urgent attention from their doctor. Methods Prospective, interventional, single case report. A 79‐year‐old male patient controlled to our department for exudative AMD since 1997. The process started in the right eye (RE), which had been treated by argon laser photocoagulation. Twelve years later, visual acuity in his left eye (LE) decreased to 5/10 and ophthalmoscopy showed a subretinal macular haemorrhage corresponding with an occult choroidal neovascular membrane in fluorescein angiography image. In this time, we decided to proceed with intravitreal ranibizumab treatment in the LE. Results Two days following de second injection, the patient is referred to our department for ocular pain with severe episcleral inflammation, located at the injection site. Not visual loss was documented. A good response to topical steroids was obtained, and so, one month later, the third injection is performed with no complications. Conclusion Intravitreal ranibizumab therapy is associated with various complications, the most of which are related with the injection procedure. However ranibizumab´s benefits are greater than its risks, for the treatment of exudative AMD.