Posters

Treatment of haemorrhagic occlusive retinal vasculitis with aflibercept

Poster Details

First Author: C. Gunasekera UK

Co Author(s): A. Mukherjee   J. Patel                 

Abstract Details

Purpose:

Haemorrhagic Occlusive Retinal Vasculitis (HORV) is a devastating complication of cataract surgery. It has been thought that there is a relationship with the use of intracameral Vancomycin at the time of surgery. With only a handful of case reports in the literature, effective treatment for this condition has not been identified. Treatment has included high dose corticosteroids, intravitreal antibiotics, pars planar vitrectomy and panretinal photocoagulation. Despite this intervention, visual outcome has been shown to be poor with neovascular glaucoma developing in many eyes. We report a case of HORV which was treated with aflibercept.

Setting:

Essex County Hospital, Colchester, United Kingdom.

Methods:

A retrospective case note review was undertaken along with correlation with retinal imaging.

Results:

A 94 year old penicillin allergic lady presented after her second cataract operation.. Her second eye had intracameral vancomycin for prophylaxis. She reported poor vision following surgery and presented 8 weeks afterwards for her post-operative review. Examination demonstrated visual acuity of counting fingers in the left eye, iris neovascularisation, intraocular pressure of 18 mmHg. Her left fundus showed macular oedema and deep retinal haemorrhages without tortuous vessels, or optic disc oedema. A presumed diagnosis of HORV was given and started on aflibercept. Her visual acuity was 3/75 on follow up with resolved macular oedema.

Conclusions:

There is still no definitive evidence as to the cause of HORV. Treatment with aflibercept seems to resolve macular oedema without a significant improvement in visual acuity in the short term. The prevalence and epidemiology of this condition is still undetermined. This case would be of interest to cataract surgeons using regular antibiotic prophylaxis during cataract surgery.

Financial Disclosure:

None