Acute vision loss associated with retinal circulatory disturbances after intravitreal injection of bevacizumab.
OBJECTIVE
Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor (VEGF), specifically binds to VEGF protein, and inhibits angiogenesis. Intravitreal/intracameral injection of bevacizumab has been reported as another treatment option for patients with various ocular ischemic conditions. However, we report 4 cases of acute vision loss after bevacizumab intravitreal injection.


METHODS
Intravitreal bevacizumab injections were administrated to 2 ocular ischemic syndrome (OIS) patients and 2 central retinal vein occlusion (CRVO) patients. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), funduscopic findings, and fluorescein angiography were evaluated before and after the treatments.


RESULTS
All 4 cases presented with acute vision loss within 1 week after bevacizumab injection, before its clearance from the eye, and showed that microcirculatory disturbances occurred in the retina.


CONCLUSIONS
We believe that intravitreal injection of bevacizumab should be undertaken with extreme caution in patients with a history of cerebral infarction, especially with OIS or nonischemic CRVO, and with diabetic retinopathy and vitrectomized eye with pseudophakia.
Department of Ophthalmology, Chungnam National University College of Medicine , Deajeon, Republic of Korea.
Young Joon
YJ
Jo
Jung Kee
JK
Min
Je Moon
JM
Woo
Jin Ho
JH
Yim
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D000068258:Bevacizumab; D006801:Humans; D058449:Intravitreal Injections; D007511:Ischemia / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D012160:Retina / Q000187:drug effects / Q000473:pathology; D012170:Retinal Vein Occlusion / Q000188:drug therapy; D013577:Syndrome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014786:Vision Disorders / Q000139:chemically induced* / Q000473:pathology; D014792:Visual Acuity / Q000187:drug effects*
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab