| Presentation preference | Oral presentation |
| Title | Sympathetic ophthalmia treated by intravitreal aflibercept |
| Purpose | To report the management of intraocular inflammation and macular edema with aflibercept in a case of sympathetic ophthalmia (SO) |
| Methods | Case Report |
| Results | A 75-year-old male with history of left eye (LE) open angle glaucoma and right eye (RE) unsuccessful retinal detachment surgery 40 years earlier, reported decreased visual acuity (VA) in his LE. VA was RE no light perception and LE 20/30. Anterior segment RE presented pseudophakia with pupillary fibrosis and atrophic hypopigmented areas; LE was phakic. Funduscopy revealed multiple choroidal granulomatous areas with macular edema and no choroidal neovascularization (CNV). Diagnosis was made of SO and an intravitreal injection of a dexamethasone sustained release system (DexaSRS) was performed, that was followed by VA improvement (20/25), resolved macular edema and increased intraocular pressure (IOP, 28 mmHg) that required triple anti glaucomatous therapy. Two months later VA decreased (20/30) with vitreous infiltration and increased macular edema. A trans Tenon injection of triamcinolone was performed and systemic immune modulation was proposed, that was rejected by Internal Medicine due to clinical history of tuberculosis. A new injection of DexaSRS was performed, followed by a new rise of IOP (32 mmHg) and cataract. After phaco surgery, two further injections of DexaSRS were performed, associated with further rises of IOP (45 mmHg), requiring quadruple anti glaucomatous therapy.
Intravitreal aflibercept at 4-weeks to 6 weeks intervals was then started, achieving an almost complete normalization of macular thickness and VA 20/25. |
| Conclusion | Our case illustrates favorable outcome of antiVEGF therapy in a case with no further therapeutical alternatives |
| Conflict of interest | No |
Authors 1
| Last name | MONTERO-MORENO |
| Initials of first name(s) | J |
| Department | Ophthalmology. Rio Hortega Hospital |
| City | Valladolid |
| Country | Spain |
Authors 2
| Last name | Diez-Montero |
| Initials of first name(s) | C |
| Department | Ophthalmology. Rio Hortega Hospital |
| City | Valladolid |
| Country | Spain |
Authors 3
| Last name | Sanchis-Merino |
| Initials of first name(s) | ME |
| Department | Allergy and Clinical Immunology. Rio Hortega Hospital |
| City | Valladolid |
| Country | Spain |
Authors 4
| Last name | Gonzalez-Uruena |
| Initials of first name(s) | C |
| Department | Ophthalmology Clinical Trials Unit. Rio Hortega Hospital |
| City | Valladolid |
| Country | Spain |
Authors 5
| Last name | Hernandez-Fernandez |
| Initials of first name(s) | R |
| Department | Ophthalmology Clinical Trials Unit. Rio Hortega Hospital |
| City | Valladolid |
| Country | Spain |
Authors 6
| Last name | Cañibano-Perez |
| Initials of first name(s) | E |
| Department | Ophthalmology Clinical Trials Unit. Rio Hortega Hospital |
| City | Valladolid |
| Country | Spain |
