April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Insight Into 102 Ocular Vascular Events During VEGF Antagonist Injections
Author Affiliations & Notes
  • Ahmad M. Mansour
    Ophthalmology, American University of Beirut, Beirut, Lebanon
  • Maha Shahin
    Ophthalmology, Mansoura University, Mansoura City, Egypt
  • Peter K. Kofoed
    Ophthalmology, University of Copenhagen, Glostrup, Denmark
  • Maurizio B. Parodi
    Ophthalmology, University Vita-Salute, Milan, Italy
  • Michel Shami
    Ophthalmology, Texas Tech University Health Sciences Center, Lubbock, Texas
  • Nikolaus Feucht
    Ophthalmology, Technical University of Munich, Munich, Germany
  • Therese von Hanno
    Ophthalmology, Nordland Hospital, Bodo, Norway
  • Claudio A. Furino
    Ophthalmology, University of Bari, Bari, Italy
  • Sabine Aisenbrey
    Ophthalmology, University of Tuebingen, Tuebingen, Germany
  • Wael Soliman
    Ophthalmology, Assiut University, Assiut, Egypt
  • Footnotes
    Commercial Relationships  Ahmad M. Mansour, None; Maha Shahin, None; Peter K. Kofoed, None; Maurizio B. Parodi, None; Michel Shami, None; Nikolaus Feucht, None; Therese von Hanno, None; Claudio A. Furino, None; Sabine Aisenbrey, None; Wael Soliman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 6682. doi:https://doi.org/
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      Ahmad M. Mansour, Maha Shahin, Peter K. Kofoed, Maurizio B. Parodi, Michel Shami, Nikolaus Feucht, Therese von Hanno, Claudio A. Furino, Sabine Aisenbrey, Wael Soliman; Insight Into 102 Ocular Vascular Events During VEGF Antagonist Injections. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6682. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To record ocular vascular events following injections of vascular endothelium growth factor (VEGF) antagonists.

Methods: : Collaborative multicenter case series (41 cases), literature review (15 cases), and reports to the FDA (46 cases) of cases that had ocular vascular occlusions during anti-VEGF therapy.

Results: : 102 cases had ocular vascular events diagnosed a median of 14 days after anti-VEGF injection. A majority of patients had preexistent risk factors for cardiovascular events and 6 patients had prior history of glaucoma. Mean visual acuity dropped by 5 lines with severe visual loss after injection to NLP (2 eyes), LP (6 eyes), and HM (2 eyes). The overall risk of ocular vascular events was 0.087%, with predilection for eyes with advanced retinal ischemia like proliferative diabetic retinopathy and ocular ischemic syndrome. Mean retinal arterial constriction after intravitreal bevacizumab in 13 eyes was 21% (standard deviation=27%) and mean venous constriction was 8% (standard deviation=30%).

Conclusions: : The ocular vascular events during anti-VEGF therapy are rare, can lead to severe visual loss, and may be of multifactorial etiologies: vasoconstrictor effect of the drug, post-injection rise of intraocular pressure, stress of the procedure, and the natural history of underlying ocular or systemic diseases.

Keywords: ischemia • injection • drug toxicity/drug effects 

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