PURPOSE: 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.
PURPOSE: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.