Purpose:

Anti-VEGF injections have been standard treatment of exudative age-related macular degeneration (ARMD) in recent years. However multiple and recurrent injections needed to maintain the efficacy of the treatment may lead to adverse side effects related to this regimen. The aim of this study was to find out ocular adverse events associated with intravitreal injection of ranibizumab for the treatment of exudative ARMD performed in a tertiary eye clinic from a relatively rural area of Turkey.

Methods:

The clinical records of 322 eyes of 235 consecutive patients undergoing intravitreal injections for the treatment of exudative AMD were retrospectively reviewed by file screening to reveal post-injection complications. All patients were treated with intravitreal 0.5 mg ranibizumab injection. Data from patient files between January 2009 and November 2012 were recorded and assessed.

Results:

Mean age of 121 male and 114 female patients were 65.32 ±14.0 years. Mean number of injections per eye was 4.3 ±1.2. Total number of injections was 1464. Ocular side effects were detected in 32 eyes (11.8%). The most common side effect was transient intraocular elevation (13 eyes) without persistence after sort-term medication. Mild anterior chamber reaction controlled by topical steroids was seen in 9 eyes. Subconjunctival haemorrhage was occurred in 18 eyes. Rupture of retinal pigment epithelium was seen in one eye. Two cases of endophthalmitis (culture-positive for Pseudomonas in one eye) occurred. Both of two returned to previous vision after the medical treatment in one and after the vitrectomy in the other case. Patients with infectious endophthalmitis presented within the first 72 hours following the intravitreal injection with complaints of pain, redness, and decreased vision. Retinal detachment or tear, subretinal haemorrhage or any other side effects was not observed.

Conclusion:

The most important complication following intravitreal injections of ranibizumab was endophthalmitis that is a rare but potentially vision-threatening problem. Prompt management approach to treat endophthalmitis may prevent irreversible vision loss.