Frosted branch angitis following intravitreal injection of aflibercept 8 mg: Case report and review of literature

In this case report, we present a male patient with rapid, painless loss of vision in the right eye since 1 week following intravitreal injection of aflibercept 8 mg. Examination revealed extensive isolated right occlusive retinal vasculitis in the form of frosted branch angitis with marked drop of best corrected visual acuity (BCVA) to hand movement. Optical coherence tomography (OCT) revealed macular thickening and intra- and subretinal fluid. Blood investigations revealed no abnormality. Therefore, a causal relationship with aflibercept 8 mg was established. Systemic steroids with gradual tapering over 11 weeks were prescribed. The BCVA gradually improved with follow-up and reached 0.6 with resolution of the intra- and subretinal fluid. Isolated frosted branch angitis may occur on top of aflibercept 8 mg injection. Meticulous follow-up and examination of all injected cases is necessary for early detection and treatment of such catastrophic complications.