Extensive Submacular Hemorrhage following Intravitreal Ranibizumab for Small Occult Choroidal Neovascular Membrane

Purpose Although intravitreal ranibizumab represents an established therapeutic approach for exudative age-related macular degeneration (AMD), the possible occurrence of adverse events remains under ongoing research. The purpose of this report is to present an incidence of an extensive submacular hemorrhage after intravitreal ranibizumab administration. Methods Interventional case report. Results A 72-year-old woman was referred to our retinal department for sudden visual loss in the right eye (RE). She had undergone an intravitreal ranibizumab injection 48 hours prior to her presentation. She had known AMD with a confirmed occult choroidal neovascularization (CNV) for which she had been subjected to a total of 24 intravitreal injections in the RE (with monthly intervals) over the last 2 years. Clinical examination revealed an extensive submacular hemorrhage in the RE. Conclusions To our knowledge, this is the first report of a submacular hemorrhage soon after ranibizumab administration in a patient with a small occult CNV. Although such a correlation cannot be established, the authors underline the possibility of such an adverse event in patients with small CNVs following a long therapeutic course involving high injection volume.