Noninfectious intraocular inflammation with hypopyon after intravitreal aflibercept 8 mg injection for neovascular age-related macular degeneration: a case report
- 1Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192 Japan
Abstract
Background: Herein, we report a case of noninfectious intraocular inflammation (IOI) with hypopyon after an intravitreal aflibercept 8 mg injection for neovascular age-related macular degeneration.
Case presentation: An 87-year-old Japanese man with neovascular age-related macular degeneration in the right eye was switched from intravitreal aflibercept 2 mg to aflibercept 8 mg to extend the treatment interval. Three days after the third aflibercept 8 mg injection, the patient presented with decreased vision without ocular pain. Slit-lamp examination revealed mild conjunctival injection and anterior chamber cells. Despite treatment with topical corticosteroids, the inflammation worsened the following day, with increased anterior chamber cells accompanied by a highly mobile hypopyon that shifted with head position. Smear microscopy of the aqueous humor showed neutrophils without detectable bacteria; the bacterial and fungal cultures were negative. Given the mild conjunctival injection, absence of ocular pain, and negative microbiological findings, noninfectious IOI was considered. The hypopyon rapidly resolved after a subconjunctival betamethasone injection on day 5. On day 8, vitritis and vitreous haze were observed and sub-Tenon triamcinolone acetonide was administered. By day 44, the best-corrected visual acuity had recovered to 20/20 and all inflammatory findings had completely resolved.
Conclusions: Noninfectious IOI with hypopyon may occur after an intravitreal aflibercept 8 mg injection. Even when hypopyon is present after an anti-vascular endothelial growth factor injection, noninfectious IOI should be included as a differential diagnosis in addition to infectious IOI.
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BibTeX
@article{kamao2026noninfectious,
title = {{Noninfectious intraocular inflammation with hypopyon after intravitreal aflibercept 8 mg injection for neovascular age-related macular degeneration: a case report}},
author = {Hiroyuki Kamao and Ryutaro Hiraki and Date Yuto and Atsushi Miki and Shuhei Kimura},
journal = {BMC Ophthalmology},
year = {2026},
month = jul,
doi = {10.1186/s12886-026-05124-w},
url = {https://doi.org/10.1186/s12886-026-05124-w},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Noninfectious intraocular inflammation with hypopyon after intravitreal aflibercept 8 mg injection for neovascular age-related macular degeneration: a case report
AU - Hiroyuki Kamao
AU - Ryutaro Hiraki
AU - Date Yuto
AU - Atsushi Miki
AU - Shuhei Kimura
PY - 2026
DA - 2026/07/30
JO - BMC Ophthalmology
DO - 10.1186/s12886-026-05124-w
UR - https://doi.org/10.1186/s12886-026-05124-w
AB - Background: Herein, we report a case of noninfectious intraocular inflammation (IOI) with hypopyon after an intravitreal aflibercept 8 mg injection for neovascular age-related macular degeneration. Case presentation: An 87-year-old Japanese man with neovascular age-related macular degeneration in the right eye was switched from intravitreal aflibercept 2 mg to aflibercept 8 mg to extend the treatment interval. Three days after the third aflibercept 8 mg injection, the patient presented with decreased vision without ocular pain. Slit-lamp examination revealed mild conjunctival injection and anterior chamber cells. Despite treatment with topical corticosteroids, the inflammation worsened the following day, with increased anterior chamber cells accompanied by a highly mobile hypopyon that shifted with head position. Smear microscopy of the aqueous humor showed neutrophils without detectable bacteria; the bacterial and fungal cultures were negative. Given the mild conjunctival injection, absence of ocular pain, and negative microbiological findings, noninfectious IOI was considered. The hypopyon rapidly resolved after a subconjunctival betamethasone injection on day 5. On day 8, vitritis and vitreous haze were observed and sub-Tenon triamcinolone acetonide was administered. By day 44, the best-corrected visual acuity had recovered to 20/20 and all inflammatory findings had completely resolved. Conclusions: Noninfectious IOI with hypopyon may occur after an intravitreal aflibercept 8 mg injection. Even when hypopyon is present after an anti-vascular endothelial growth factor injection, noninfectious IOI should be included as a differential diagnosis in addition to infectious IOI.
SN - 1471-2415
ER -