Retinal vascular events after intravitreal bevacizumab.
OBJECTIVE
To record retinal vascular events following intravitreal bevacizumab injection.


METHODS
Collaborative multi-centre retrospective case series.


RESULTS
Eight patients were documented to have central retinal artery occlusion (four patients), branch retinal artery occlusion, capillary occlusion, central retinal vein occlusion and branch retinal vein occlusion (one patient each) within 0-55 days (median 2 weeks) of intravitreal bevacizumab. All patients had several ocular and systemic risk factors for retinal vascular events: elevated intraocular pressure on discharge (four patients), pre-existent glaucoma (one patient), pre-existent ischaemic retinal vascular disorder (four patients), systemic hypertension (five patients), diabetes mellitus (three patients), coronary artery disease (four patients), carotid disease (three patients), smoking (two patients) and migraine (one patient).


CONCLUSIONS
The retinal vascular events may be associated with the underlying ocular disease under treatment or with the underlying systemic disease, may be related to an increased intraocular pressure post-injection constraining further an already poor retinal perfusion, the vasoconstrictor effect of bevacizumab, or a combination of all three.
Mansour
Ahmad M
AM
Department of Ophthalmology, American University of Beirut, Rafic Hariri University Hospital, Lebanon. dr.ahmad@cyberia.net.lb
Bynoe
Leon A
LA
Welch
John C
JC
Pesavento
Richard
R
Mahendradas
Padmamalini
P
Ziemssen
Focke
F
Pai
Sivakami A
SA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003324:Coronary Artery Disease / Q000150:complications; D003930:Diabetic Retinopathy; D005128:Eye Diseases / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D005901:Glaucoma / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D056965:Injections, Intraocular; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000150:complications; D015356:Retinal Artery Occlusion / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology*; D012164:Retinal Diseases / Q000150:complications; D012170:Retinal Vein Occlusion / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014662:Vasoconstrictor Agents / Q000009:adverse effects; D014822:Vitreous Body
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014662:Vasoconstrictor Agents; D000068258:Bevacizumab