Literature DB >> 30249866

Response to comment on: Rebound inflammation after an intravitreal injection in Vogt-Koyanagi-Harada syndrome.

Richa Ranjan1, Manisha Agarwal1.   

Abstract

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Year:  2018        PMID: 30249866      PMCID: PMC6173022          DOI: 10.4103/ijo.IJO_1221_18

Source DB:  PubMed          Journal:  Indian J Ophthalmol        ISSN: 0301-4738            Impact factor:   1.848


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Sir, We thank the author for the comments.[1] We agree that there is a possibility of ocular inflammation associated with intravitreal bevacizumab injection. On review of literature, the various manifestations of sporadic and “herd” ocular inflammation secondary to bevacizumab which have been reported are mild to moderate conjunctival hyperemia with Descemet's membrane striae,[2] keratitic precipitates,[2] anterior chamber cell and flare,[23] hypopyon,[2] and vitritis.[23] However, exudative retinal detachment (RD) after intravitreal bevacizumab injection has not been reported in the past. It is therefore unlikely to be secondary to intravitreal bevacizumab injection and more suggestive of recurrence of Vogt–Koyanagi–Harada syndrome. To answer the question raised by the author, five other patients received intravitreal bevacizumab injection from the same bevacizumab vial, but none of them developed any signs of inflammation on follow-up. We agree that an intravitreal injection produces a micro injury; however, the literature have reports of Vogt–Koyanagi–Harada syndrome after cutaneous injury[4] and even closed head trauma.[5] A micro injury at the site of pars plana may release enough uveal melanocytes to trigger an inflammatory response in a genetically susceptible individual. Therefore, we postulated that the exudative RD was due to the reactivation of Vogt–Koyanagi–Harada syndrome rather than an inflammation due to bevacizumab.

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Conflicts of interest

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  5 in total

1.  Vogt-Koyanagi-Harada syndrome after cutaneous injury.

Authors:  S R Rathinam; P Namperumalsamy; R A Nozik; E T Cunningham
Journal:  Ophthalmology       Date:  1999-03       Impact factor: 12.079

2.  Acute intraocular inflammation caused by endotoxin after intravitreal injection of counterfeit bevacizumab in Shanghai, China.

Authors:  Fenghua Wang; Suqin Yu; Kun Liu; Feng-E Chen; Zhengyu Song; Xi Zhang; Xun Xu; Xiaodong Sun
Journal:  Ophthalmology       Date:  2012-10-18       Impact factor: 12.079

3.  Vogt-Koyanagi-Harada disease after head trauma.

Authors:  M Accorinti; M P Pirraglia; C Corsi; C Caggiano
Journal:  Eur J Ophthalmol       Date:  2007 Sep-Oct       Impact factor: 2.597

4.  Managing bevacizumab-induced intraocular inflammation.

Authors:  Subijay Sinha; Nagender Vashisht; Pradeep Venkatesh; Sat Pal Garg
Journal:  Indian J Ophthalmol       Date:  2012-07       Impact factor: 1.848

5.  Comment on: Rebound inflammation after an intravitreal injection in Vogt-Koyanagi-Harada syndrome.

Authors:  Manish Jain
Journal:  Indian J Ophthalmol       Date:  2018-10       Impact factor: 1.848

  5 in total

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