J Korean Ophthalmol Soc.  2012 Dec;53(12):1893-1897. 10.3341/jkos.2012.53.12.1893.

Acute Visual Loss after Intravitreal Bevacizumab Injection in a Patient with Ocular Ischemic Syndrome

Affiliations
  • 1Department of Ophthalmology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea. bswhitey@hanmail.net

Abstract

PURPOSE
To report a patient with ocular ischemic syndrome who suffered from sudden decrease in visual acuity after bevacizumab injection.
CASE SUMMARY
A 70-year-old patient visited the Department of Ophthalmology due to progressively decreasing visual acuity in the right eye. Corrected visual acuity in his right eye was 0.1 on the first visit; ocular ischemic syndrome was suspected. Despite panretinal photocoagulation, severe iris neovascularization was still present in the right eye. Intravitreal bevacizumab injection was performed to regress the iris neovascularization. One day after injection, iris neovascularization regressed significantly, however, visual acuity was decreased to finger counting.
CONCLUSIONS
In ocular ischemic syndrome, bevacizumab injection for reduction of iris neovascularization should be carefully considered due to possibility of acute visual loss.

Keyword

Intravitreal bevacizumab; Iris neovascularization; Ocular ischemic syndrome

MeSH Terms

Aged
Antibodies, Monoclonal, Humanized
Eye
Fingers
Humans
Iris
Light Coagulation
Ophthalmology
Visual Acuity
Bevacizumab
Antibodies, Monoclonal, Humanized

Figure

  • Figure 1 Fundus photography shows diffuse retinal arteriolar narrowing.

  • Figure 2 Fluorescein angiography of patient's right eye. (A) Early phase in fluorescein angiography shows delayed arm-to-retina time. (B) Early phase in fluorescein angiography shows delayed choroidal filling. (C) Late phase in fluorescein angiography shows incomplete fluorescein filling of retinal vein.

  • Figure 3 Computed tomography angiography shows total occlusion of right internal carotid artery (arrow).


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