J Korean Ophthalmol Soc.  2014 May;55(5):780-784. 10.3341/jkos.2014.55.5.780.

Vitreous Web after Pars Plana Vitrectomy and Bevacizumab Injection

• Kim M
• Chae JB

• KMID: 2218104
• DOI: http://doi.org/10.3341/jkos.2014.55.5.780

Abstract

PURPOSE
To report a case of vitreous inflammation (vitreous web) after intravitreal bevacizumab injection accompanying pars plana vitrectomy (PPV) for the treatment of proliferative diabetic retinopathy with vitreous hemorrhage.
CASE SUMMARY
A 41-year-old female who underwent panretinal photocoagulation for diabetes mellitus (DM) retinopathy presented with decreased visual acuity in her right eye which was caused by vitreous hemorrhage. The patient underwent PPV with intravitreal bevacizumab injection. One day after surgery, the vitreous hemorrhage cleared and there was no inflammation in the anterior segment; however, multiple inflammatory white strands (vitreous web) were found in the vitreous cavity. She was diagnosed with non-infectious endophthalmitis and treated with topical steroid and additional oral steroids, resulting in clearance of the vitreous web on postoperative day 4. One month later, vitreous hemorrhage occurred in the other eye. PPV without bevacizumab injection cleared the vitreous hemorrhage with no evidence of vitreous web.
CONCLUSIONS
Vitreous web-like inflammation can occur after intravitreal bevacizumab injection accompanying PPV for the treatment of DM vitreous hemorrhage. After eliminating infectious endophthalmitis based on lack of pain, conjunctival injection, anterior chamber hypopyon, and inflammatory cells, the web can be cleared without invasive intravitreal antibiotics injections.

Keyword

Intraocular inflammation; Vitreous hemorrhage

MeSH Terms

Adult
Anterior Chamber
Anti-Bacterial Agents
Diabetes Mellitus
Diabetic Retinopathy
Endophthalmitis
Female
Humans
Inflammation
Light Coagulation
Steroids
Visual Acuity
Vitrectomy*
Vitreous Hemorrhage
Bevacizumab
Anti-Bacterial Agents
Steroids

Figure

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  Figure 1. Vitreous hemorrhage is observed in the right eye (A). At postoperative day 1, multiple inflammatory web-like white strands (vitreous web) are seen (B). At postoperative day 4, multiple inflammatory web-like white strands (vitreous web) disappeared (C). At postoperative 1 month, there are no multiple inflammatory web-like white strands (vitreous web) (D). At postoperative day 1 and 1 month, there are no inflammatory web-like white strands (vitreous web) at left eye (E, F).

Reference

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