Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients

Vincenzo Isola,1 Alfredo Pece,1,2 Claudio Massironi,1 Simone Reposi,1 Fabio Dimastrogiovanni11Department of Ophthalmology, Melegnano Hospital, 2Fondazione Retina 3000, Milano, ItalyBackground: Ischemic changes in the retinal circulation are an uncommon but severe adverse vascular reaction to intravi...

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Autores principales:	Isola V, Pece A, Massironi C, Reposi S, Dimastrogiovanni F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/25dd725bcc0a4193a9cf48c51f8df6e4
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spelling	oai:doaj.org-article:25dd725bcc0a4193a9cf48c51f8df6e42021-12-02T02:18:48ZAccelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients1177-54671177-5483https://doaj.org/article/25dd725bcc0a4193a9cf48c51f8df6e42013-03-01T00:00:00Zhttp://www.dovepress.com/accelerated-ischemic-vascular-retinopathy-after-intravitreally-injecte-a12336https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Vincenzo Isola,1 Alfredo Pece,1,2 Claudio Massironi,1 Simone Reposi,1 Fabio Dimastrogiovanni11Department of Ophthalmology, Melegnano Hospital, 2Fondazione Retina 3000, Milano, ItalyBackground: Ischemic changes in the retinal circulation are an uncommon but severe adverse vascular reaction to intravitreal bevacizumab (Avastin&reg;, Genentech, San Francisco, CA, USA/Roche, Basel, Switzerland) for central retinal vein occlusion (CRVO). In the two cases reported here, ischemic changes in the retina vasculature following intravitreal bevacizumab for CRVO were observed with the aim of describing the clinical and angiographic features of these changes.Methods: Two elderly patients with recent-onset CRVO received one off-label intravitreal injection of bevacizumab 0.05 mL/1.25 mg.Results: In Case 1, the patient&#39;s pre-treatment visual acuity was 20/400. At 3 weeks post injection, the patient could count fingers at a distance of 1 ft (30 cm) and fluorescein angiography showed reduction in intraretinal hemorrhages and areas of retinal non-perfusion. However, at 6 weeks these were markedly increased compared with those seen in the photograph taken 3 weeks after treatment. In Case 2, the patient&#39;s pre-treatment visual acuity was 20/200. At 1 month post injection, vision had decreased to 20/400 and fluorescein angiography showed severe macular ischemia with a remarkable capillary dropout throughout the macula.Conclusion: Ischemic retinal injury may be an uncommon but severe adverse vascular reaction to intravitreal bevacizumab for CRVO. Although progression of retinal ischemia in CRVO could be observed shortly after intravitreal bevacizumab, whether this is a drug- or procedure-related effect or part of the natural history of the condition remains uncertain.Keywords: Avastin, ischemia, macular infarction, intraretinal hemorrhage, retinal non-perfusionIsola VPece AMassironi CReposi SDimastrogiovanni FDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 455-460 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Isola V Pece A Massironi C Reposi S Dimastrogiovanni F Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients
description	Vincenzo Isola,1 Alfredo Pece,1,2 Claudio Massironi,1 Simone Reposi,1 Fabio Dimastrogiovanni11Department of Ophthalmology, Melegnano Hospital, 2Fondazione Retina 3000, Milano, ItalyBackground: Ischemic changes in the retinal circulation are an uncommon but severe adverse vascular reaction to intravitreal bevacizumab (Avastin&reg;, Genentech, San Francisco, CA, USA/Roche, Basel, Switzerland) for central retinal vein occlusion (CRVO). In the two cases reported here, ischemic changes in the retina vasculature following intravitreal bevacizumab for CRVO were observed with the aim of describing the clinical and angiographic features of these changes.Methods: Two elderly patients with recent-onset CRVO received one off-label intravitreal injection of bevacizumab 0.05 mL/1.25 mg.Results: In Case 1, the patient&#39;s pre-treatment visual acuity was 20/400. At 3 weeks post injection, the patient could count fingers at a distance of 1 ft (30 cm) and fluorescein angiography showed reduction in intraretinal hemorrhages and areas of retinal non-perfusion. However, at 6 weeks these were markedly increased compared with those seen in the photograph taken 3 weeks after treatment. In Case 2, the patient&#39;s pre-treatment visual acuity was 20/200. At 1 month post injection, vision had decreased to 20/400 and fluorescein angiography showed severe macular ischemia with a remarkable capillary dropout throughout the macula.Conclusion: Ischemic retinal injury may be an uncommon but severe adverse vascular reaction to intravitreal bevacizumab for CRVO. Although progression of retinal ischemia in CRVO could be observed shortly after intravitreal bevacizumab, whether this is a drug- or procedure-related effect or part of the natural history of the condition remains uncertain.Keywords: Avastin, ischemia, macular infarction, intraretinal hemorrhage, retinal non-perfusion
format	article
author	Isola V Pece A Massironi C Reposi S Dimastrogiovanni F
author_facet	Isola V Pece A Massironi C Reposi S Dimastrogiovanni F
author_sort	Isola V
title	Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients
title_short	Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients
title_full	Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients
title_fullStr	Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients
title_full_unstemmed	Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients
title_sort	accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/25dd725bcc0a4193a9cf48c51f8df6e4
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Accelerated ischemic vascular retinopathy after intravitreally injected bevacizumab for central retinal vein occlusion in elderly patients

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