Insight into 144 patients with ocular vascular events during VEGF antagonist injections

Ahmad M Mansour1, Maha Shahin2, Peter K Kofoed3, Maurizio B Parodi4, Michel Shami5, Stephen G Schwartz6, Collaborative Anti-VEGF Ocular Vascular Complications GroupDepartment of Ophthalmology, 1American University of Beirut, Beirut, Lebanon, Rafic Hariri University Hospital, Beirut, Lebanon; 2Mansou...

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Autores principales:	Shami M, Parodi MB, Mansour AM, Kofoed PK, Shahin M, Schwartz SG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/19df5b6c95ae4b2abcd64494f3118f93
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spelling	oai:doaj.org-article:19df5b6c95ae4b2abcd64494f3118f932021-12-02T05:01:40ZInsight into 144 patients with ocular vascular events during VEGF antagonist injections1177-54671177-5483https://doaj.org/article/19df5b6c95ae4b2abcd64494f3118f932012-03-01T00:00:00Zhttp://www.dovepress.com/insight-into-144-patients-with-ocular-vascular-events-during-vegf-anta-a9421https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Ahmad M Mansour1, Maha Shahin2, Peter K Kofoed3, Maurizio B Parodi4, Michel Shami5, Stephen G Schwartz6, Collaborative Anti-VEGF Ocular Vascular Complications GroupDepartment of Ophthalmology, 1American University of Beirut, Beirut, Lebanon, Rafic Hariri University Hospital, Beirut, Lebanon; 2Mansoura University, Mansoura City, Egypt; 3Glostrup Hospital, University of Copenhagen, Denmark, National Eye Clinic, Kennedy Center, Glostrup, Denmark; 4University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy; 5Texas Tech University Health Sciences Center, Lubbock, TX, USA; 6Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples and Miami, FL, USAAim: To record ocular vascular events following injections of vascular endothelium growth factor (VEGF) antagonists.Methods: Collaborative multicenter case series (48 cases), literature reviews (32 cases), and reports to the FDA (64 cases) of patients that had vascular occlusions during anti-VEGF therapy were collected and analyzed.Results: A total of 144 cases of ocular vascular events were identified, with these diagnosed a median of 15 days after anti-VEGF injection. The majority of patients had pre-existing risk factors for cardiovascular events and nine patients had a prior history of glaucoma. Mean visual acuity dropped by 6.4 lines with severe visual loss after injection to NLP (five eyes), LP (six eyes), and HM (two eyes). The overall risk of ocular vascular events following a VEGF antagonist injection was 0.108% in the general population and 2.61% in the diabetic population. Mean retinal arterial constriction after intravitreal bevacizumab in 13 eyes was 21% (standard deviation = 27%), and mean retinal venous constriction was 8% (standard deviation = 30%).Conclusion: Ocular vascular events are rare during anti-VEGF therapy, but can lead to severe visual loss and may be caused by a number of factors including the vasoconstrictor effect of the drug, a post-injection rise of intraocular pressure, patient stress as a result of the procedure, and the patient&#39;s natural history of underlying ocular or systemic diseases. The diabetic population appears to have a tendency towards ocular vascular occlusions.Keywords: Bevacizumab, retinal artery occlusion, retinal vein occlusion, retinal capillary occlusion, ranibizumabShami MParodi MBMansour AMKofoed PKShahin MSchwartz SGDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 343-363 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Shami M Parodi MB Mansour AM Kofoed PK Shahin M Schwartz SG Insight into 144 patients with ocular vascular events during VEGF antagonist injections
description	Ahmad M Mansour1, Maha Shahin2, Peter K Kofoed3, Maurizio B Parodi4, Michel Shami5, Stephen G Schwartz6, Collaborative Anti-VEGF Ocular Vascular Complications GroupDepartment of Ophthalmology, 1American University of Beirut, Beirut, Lebanon, Rafic Hariri University Hospital, Beirut, Lebanon; 2Mansoura University, Mansoura City, Egypt; 3Glostrup Hospital, University of Copenhagen, Denmark, National Eye Clinic, Kennedy Center, Glostrup, Denmark; 4University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy; 5Texas Tech University Health Sciences Center, Lubbock, TX, USA; 6Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples and Miami, FL, USAAim: To record ocular vascular events following injections of vascular endothelium growth factor (VEGF) antagonists.Methods: Collaborative multicenter case series (48 cases), literature reviews (32 cases), and reports to the FDA (64 cases) of patients that had vascular occlusions during anti-VEGF therapy were collected and analyzed.Results: A total of 144 cases of ocular vascular events were identified, with these diagnosed a median of 15 days after anti-VEGF injection. The majority of patients had pre-existing risk factors for cardiovascular events and nine patients had a prior history of glaucoma. Mean visual acuity dropped by 6.4 lines with severe visual loss after injection to NLP (five eyes), LP (six eyes), and HM (two eyes). The overall risk of ocular vascular events following a VEGF antagonist injection was 0.108% in the general population and 2.61% in the diabetic population. Mean retinal arterial constriction after intravitreal bevacizumab in 13 eyes was 21% (standard deviation = 27%), and mean retinal venous constriction was 8% (standard deviation = 30%).Conclusion: Ocular vascular events are rare during anti-VEGF therapy, but can lead to severe visual loss and may be caused by a number of factors including the vasoconstrictor effect of the drug, a post-injection rise of intraocular pressure, patient stress as a result of the procedure, and the patient&#39;s natural history of underlying ocular or systemic diseases. The diabetic population appears to have a tendency towards ocular vascular occlusions.Keywords: Bevacizumab, retinal artery occlusion, retinal vein occlusion, retinal capillary occlusion, ranibizumab
format	article
author	Shami M Parodi MB Mansour AM Kofoed PK Shahin M Schwartz SG
author_facet	Shami M Parodi MB Mansour AM Kofoed PK Shahin M Schwartz SG
author_sort	Shami M
title	Insight into 144 patients with ocular vascular events during VEGF antagonist injections
title_short	Insight into 144 patients with ocular vascular events during VEGF antagonist injections
title_full	Insight into 144 patients with ocular vascular events during VEGF antagonist injections
title_fullStr	Insight into 144 patients with ocular vascular events during VEGF antagonist injections
title_full_unstemmed	Insight into 144 patients with ocular vascular events during VEGF antagonist injections
title_sort	insight into 144 patients with ocular vascular events during vegf antagonist injections
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/19df5b6c95ae4b2abcd64494f3118f93
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Insight into 144 patients with ocular vascular events during VEGF antagonist injections

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