J Korean Ophthalmol Soc.  2009 Nov;50(11):1751-1754.

Tractional Retinal Detachment After Intravitreal Bevacizumab (Avastin(R)) Injection in Proliferative Diabetic Retinopathy

• Song HJ
• Sohn HJ
• Lee DY
• Nam DH

Abstract

PURPOSE
To report two cases of tractional retinal detachment after intravitreal bevacizumab injection.
CASE SUMMARY
(Case 1) A 48-year-old female with insulin-dependent diabetes mellitus and a high HbA1c level came to our clinic for fundus evaluation. The best corrected visual acuity (BCVA) was 1.0 in the right eye and funduscopic examination of the right eye revealed proliferative diabetic retinopathy with preretinal hemorrhage and a mild fibrovascular proliferative membrane around the optic disc. Intravitreal bevacizumab injection (1.25 mg) was performed before starting panretinal photocoagulation (PRP) to prevent macular edema after PRP. Three days after the injection, visual acuity decreased to 0.3 and funduscopic findings showed tractional retinal detachment. Vitrectomy was performed and visual acuity recovered to 1.0 four months after operation.
CONCLUSIONS
Intravitreal bevacizumab injection may cause tractional retinal detachment in poorly controlled insulin-dependent diabetes mellitus patients with fibrovascular proliferative membranes.

Keyword

Bevacizumab; Proliferative diabetic retinopathy; Tractional retinal detachment

MeSH Terms

Antibodies, Monoclonal, Humanized
Diabetes Mellitus, Type 1
Diabetic Retinopathy
Eye
Female
Hemorrhage
Humans
Light Coagulation
Macular Edema
Membranes
Middle Aged
Porphyrins
Retinal Detachment
Retinaldehyde
Traction
Visual Acuity
Vitrectomy
Bevacizumab
Antibodies, Monoclonal, Humanized
Porphyrins
Retinaldehyde

Figure

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  Figure 1. Fundus photography and optical coherence tomography of case 1 (A) At the initial visit, mild proliferative fibrovascular membrane and neovascularization around the optic disc and preretinal hemorrhage were seen in fundus photography. No macular edema was noted in OCT. (B) At one week after intravitreal bevacizumab injection, regressed but contractured fibrovascular proliferative membrane, tractional retinal detachment involving the fovea, decreased preretinal hemorrhage was seen in fundus photography. Tractional retinal detachment was noted in OCT. (C) At postoperative four months, well attached retina was seen in fundus photography and OCT.

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  Figure 2. Fundus photography and optical coherence tomography of case 2 (A) At the initial visit, fibrovascular proliferative membrane around the optic disc, neovascularization at the disc and elsewhere, vitreous hemorrhage, macular edema were seen in fundus photography. No macular edema was noted in OCT. (B) At one month after intravitreal bevacizumab injection, dense fibrous tissue contraction, tractional retinal detachment, decreased vitreous hemorrhage were seen in fundus photography. Tractional retinal detachment was noted in OCT. (C) At three months after silicone oil removal, well attached retina was seen in fundus photography and OCT.

Reference

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