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Deepak Mangla, Manjot Gill, Susan E Quaggin; Anti-VEGF induced nephropathy following intravitreal administration: a potential toxicity.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):202.
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© ARVO (1962-2015); The Authors (2016-present)
Anti-VEGF induced kidney injury has rarely been described in the ophthalmology literature. Consideration of this potential toxicity will become increasingly important as the use and indications of anti-VEGF treatment are broadened.
This is a case report and review of the literature. We present a patient with neovascular AMD receiving anti-VEGF injections who developed declining renal function. We reviewed both the opthalmology literature and nephrology literature for renal injury secondary to alterations in systemic VEGF levels.
After extensive work-up to exclude other etiologies for renal failure including renal biopsy, injections were halted temporarily per the nephrology service. A renal biopsy showed chronic tubule-interstitial disease.
The nephrology team believed the renal injury to be secondary to ocular anti-VEGF injections. Studies have shown that serum VEGF levels are depressed following intraocular anti-VEGF injection, however the extent is dictated by each drug’s pharmacokinetics. Ophthalmologists should be aware of this entity as patients may require pretreatment counseling particularly for those with pre-existing renal disease. Close monitoring of the patient may be required in order to assess renal function before and after the intravitreal administration of anti-VEGF.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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