This 58YO female with panuveitis treated with bilateral fluocinolone acetonide intravitreal implants (Iluvien) and systemic adalimumab presented with an intermittent, moving floater near the visual axis in her right eye. She was pseudophakic in both eyes with posterior chamber intraocular lenses (IOLs) positioned within intact capsular bags.
External slit-lamp photography and anterior segment OCT show an Iluvien implant in the anterior vitreous cavity just behind the IOL.
Learning Points:
Migration of Iluvien implants into the visual axis has been reported and may cause visually disturbing symptoms, particularly when the implant assumes a vertical orientation within the vitreous cavity. In selected cases, Nd:YAG laser disruption of anchoring vitreous fibers (Moisseiev et al JAMA Ophthalmol 2016:134:1057-1058) or vitrectomy (Knight et al Retinal Cases & Brief Reports 2023;17:26-28) have been described as potential management strategies.
