This case report describes an unusual case of late-onset larynx angioedema after ranibizumab intravitreal injection. A 72-year-old female patient presented to our clinic for decreased vision; right eye (RE) fundoscopy and optical coherence tomography (OCT) revealed mild chorioretinal atrophy and choroidal neovascularization with subretinal fluid. A ranibizumab injection was planned in the RE, with standard pretreatment with daily oral administration of betamethasone, cetirizine, and ranitidine because her medical history revealed two adverse drug reactions (ADRs) to contrast media (CM). Despite the premedication, 2 h after injection, the patient referred throat closing sensation and dyspnea that resolved within few hours by betamethasone 4 mg intramuscular injection, without further reoccurrence. In occasion of the second intravitreal injection, video rhinofibrolaryngoscopy revealed subglottic edema that resolved within few hours by betamethasone 4 mg intramuscular injection. This report suggests that, even in cases of intravitreal injection, patients with history of allergy, despite the anti-allergic treatment, should be hospitalized to detect late onset of such a life-threatening complication.

本病例报告描述了玻璃体内注射雷珠单抗后出现迟发性喉部血管性水肿的罕见病例。一位72岁的女性患者因视力下降到我们诊所就诊；右眼（RE）眼底镜检查和光学相干断层扫描（OCT）显示轻度脉络膜视网膜萎缩和脉络膜新生血管伴视网膜下液。RE 计划注射雷珠单抗，并进行标准预处理，每天口服倍他米松、西替利嗪和雷尼替丁，因为她的病史显示有两次对造影剂 (CM) 的药物不良反应 (ADR)。尽管进行了术前用药，但注射后 2 小时，患者仍出现咽喉闭合感和呼吸困难，肌肉注射倍他米松 4 mg 后数小时内缓解，没有再出现。在第二次玻璃体内注射时，视频鼻纤维喉镜检查显示声门下水肿，通过​​肌肉注射倍他米松 4 mg 在几小时内消退。该报告建议，即使在玻璃体内注射的情况下，有过敏史的患者，尽管接受了抗过敏治疗，仍应住院治疗，以发现这种危及生命的并发症的晚期发作。