title: Serum D-dimer levels to evaluate the risk for arterial thromboembolism after intravitreal injection of bevacizumab and ranibizumab.
abstract: OBJECTIVE
  There are concerns about arterial thromboembolic event after intravitreal injection of bevacizumab or ranibizumab. Motivated by the fact that D-dimer was a sensitive biomarker for thromboembolism, we evaluated serum D-dimer levels in patients with age-related macular degeneration (AMD) after intravitreal injection of bevacizumab and ranibizumab.
  
  
  METHODS
  In this prospective, nonrandomized, uncontrolled study, 122 patients (122 eyes) with AMD were enrolled. Sixty-two eyes received intravitreal injections of bevacizumab and 60 eyes received intravitreal injections of ranibizumab monthly for 3 months. Serum D-dimer levels were measured in patients before intravitreal injection and 1 day, 1 week, 1 month, and 3 months thereafter.
  
  
  RESULTS
  Serum D-dimer levels were not significantly altered following injection of either bevacizumab or ranibizumab. Subgroup analysis for patients at risk for thromboembolic events revealed that serum D-dimer levels showed no significant change after injection of ranibizumab. However, D-dimer levels significantly increased at 1 day (P=0.041) and 1 week (P=0.022) after injection of bevacizumab.
  
  
  CONCLUSIONS
  Serum D-dimer levels were not changed after injection with either bevacizumab or ranibizumab. In subgroup analysis, bevacizumab injection in patients at risk of thromboembolism increased serum D-dimer levels.
authors.affiliation: 1 Department of Ophthalmology and Visual Science, St. Vincent Hospital , Suwon, Republic of Korea.
authors.forename: Donghyun
authors.initials: D
authors.lastname: Jee
authors.forename: Masahiro
authors.initials: M
authors.lastname: Zako
authors.forename: Tae Yoon
authors.initials: TY
authors.lastname: La
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D000068258:Bevacizumab; D054316:Biomarkers, Pharmacological / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069579:Ranibizumab; D013923:Thromboembolism / Q000097:blood*; D057135:Wet Macular Degeneration / Q000097:blood* / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D054316:Biomarkers, Pharmacological; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D000068258:Bevacizumab; D000069579:Ranibizumab