A 70-year-old White emmetropic female patient with neovascular age-related macular degeneration had received aflibercept intravitreal injections without complications over years. One day after an uneventful first injection of faricimab using a superonasal pars plana approach and a 30-gauge needle, she presented with pain and a subjective visual field defect. She had stable visual acuity of 20/400 OS, hypotony (intraocular pressure of 3 mm Hg), and a suprachoroidal hemorrhage (SCH) (Figure). Patching and application of tobramycin-dexamethasone ophthalmic ointment were recommended. The hypotony resolved within days, and the SCH resolved 2 months after injection. Visual acuity remained 20/400 OS. Suprachoroidal hemorrhages after intravitreal injections using small-gauge needles have been reported but are rare.1- 3 Risk factors for SCH include anticoagulation4 and high myopia,5 but these were not present in this patient, where postinjection ocular hypotony may have been the initial event leading to rupture of ciliary artery branches6 with subsequent SCH. This limited, nonappositional case of SCH resolved without surgery.
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Corresponding Author: Etienne Schönbach, MD, Jacobs Retina Center at the Shiley Eye Institute, University of California, San Diego, 9415 Campus Point Dr, La Jolla, CA 92093 (email@example.com).
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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