Insight into 144 patients with ocular vascular events during VEGF antagonist injections

Insight into 144 patients with ocular vascular events during VEGF antagonist injections

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Ahmad M Mansour1, Maha Shahin2, Peter K Kofoed3, Maurizio B Parodi4, Michel Shami5, Stephen G Schwartz6, Collaborative Anti-VEGF Ocular Vascular Complications GroupDepartment of Ophthalmology, 1American University of Beirut, Beirut, Lebanon, Rafic Hariri University Hospital, Beirut, Lebanon; 2Mansoura University, Mansoura City, Egypt; 3Glostrup Hospital, University of Copenhagen, Denmark, National Eye Clinic, Kennedy Center, Glostrup, Denmark; 4University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy; 5Texas Tech University Health Sciences Center, Lubbock, TX, USA; 6Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples and Miami, FL, USAAim: To record ocular vascular events product following injections of vascular endothelium growth factor (VEGF) antagonists.Methods: Collaborative multicenter case series (48 cases), literature reviews (32 cases), and reports to the FDA (64 cases) of patients that had vascular occlusions during anti-VEGF therapy were collected and analyzed.Results: A total of 144 cases of ocular vascular events were identified, with these diagnosed a median of 15 days after anti-VEGF injection.The majority of patients had pre-existing risk factors for cardiovascular events and nine patients had a prior history of glaucoma.Mean visual acuity dropped by 6.

4 lines with severe visual loss after injection to NLP (five eyes), LP (six eyes), and HM (two eyes).The overall risk of ocular vascular events following a VEGF antagonist injection was 0.108% in the general population and 2.61% in the diabetic population.Mean retinal arterial constriction after intravitreal bevacizumab in 13 eyes was 21% (standard deviation = 27%), and mean retinal venous constriction was 8% (standard deviation = 30%).

Conclusion: Ocular vascular events are rare during anti-VEGF therapy, but can lead to severe visual loss and may be caused by a number of factors including the vasoconstrictor effect of the drug, a post-injection rise of intraocular pressure, patient stress as a result of the procedure, and the patient's natural history of underlying ocular or systemic diseases.The diabetic population appears to have a tendency towards ocular vascular occlusions.Keywords: Bevacizumab, retinal artery occlusion, retinal vein occlusion, anodized pearl price xbox retinal capillary occlusion, ranibizumab.