Acute stroke after intravitreal bevacizumab to treat choroidal neovascularization due to angioid streaks in pseudoxanthoma elasticum

Besozzi, Gianluca; Ferrara, Andrea; Epifani, Enrico; Intini, Daniela; Apruzzese, Margherita; Provenzano, Antonio; Vetrugno, Michele

doi:10.1007/s10792-012-9647-9

Cited by 11 publications

(4 citation statements)

References 19 publications

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“…Several studies have shown that anti-VEGF injections can be used safely to treat patients. 2–4,6 However, Besozzi et al 7 discussed a patient who had an acute stroke after receiving a bevacizumab injection and raised concern over using bevacizumab off-label to treat patients with CNV secondary to PXE. This is due to the fact that PXE seems to be associated with increased risk of developing a stroke.…”

Section: Discussionmentioning

confidence: 99%

Pseudoxanthoma Elasticum: Successful Long-Term Management of Choroidal Neovascularization Secondary to Angioid Streaks With Pro Re Nata Intravitreal Bevacizumab Injections

Kim

Dalziel

2021

RETINAL Cases &Amp; Brief Reports

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Purpose: To demonstrate how a patient with recurrent episodes of choroidal neovascularization (CNV), secondary to angioid streaks, can be managed successfully with a pro re nata regime of intravitreal bevacizumab injection over an eight-year period.Method: A 32-year-old white woman with pseudoxanthoma elasticum has been followed up over an eight-year period for management of recurrent episodes of CNV in both eyes. She was educated to recognize the early signs and symptoms of CNV. Physical examination including visual acuity and slit-lamp examination as well as investigations such as macula optical coherence tomography and optical coherence tomography angiography were performed. Bevacizumab injections were given to her when she was diagnosed with CNV.Results: Multiple episodes of CNV were successfully treated with pro re nata regimes of intravitreal bevacizumab injections. The patient was able to maintain excellent visual acuity of 0 logarithm of the minimum angle of resolution even after suffering recurrent episodes of CNV.Conclusion: This case report supports that a pro re nata regime of intravitreal bevacizumab injection therapy can be used successfully to treat recurrent episodes of CNV in a patient with pseudoxanthoma elasticum over an eight-year period. Early diagnosis through patient education and the use of appropriate diagnostic tools such as optical coherence tomography angiography have enabled us to deliver early treatment, resulting in an excellent outcome for this patient.

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Section: Discussionmentioning

confidence: 99%

Pseudoxanthoma Elasticum: Successful Long-Term Management of Choroidal Neovascularization Secondary to Angioid Streaks With Pro Re Nata Intravitreal Bevacizumab Injections

Kim

Dalziel

2021

RETINAL Cases &Amp; Brief Reports

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“…Besozzi et al . [ 24 ] have reported acute stoke within 3 days of injection in a patient with PXE and no other systemic illness. Although one patient in our cohort developed two thromboembolic events, it is difficult to establish a causal relationship with IVB as he had other risk factors such as systemic hypertension and diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab for choroidal neovascularization associated with angioid streaks: Long-term results

Lekha

Prasad²,

Sarwate

et al. 2017

Middle East Afr J Ophthalmol

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PURPOSE:The purpose of the study was to evaluate the long-term efficacy and safety of intravitreal bevacizumab (IVB) in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks (AS).MATERIALS AND METHODS:Noncomparative, interventional retrospective case series involving ten patients (15 eyes) with a minimum follow-up of 25 months following IVB for AS-associated CNV. Demographic and clinical details at baseline and during follow-up were collected from patient records. Detailed clinical examination was followed by fundus fluorescein angiography and optical coherence tomography to confirm CNV. Both primary and recurrent CNVs were treated with monthly injections of IVB till the lesion stabilized. Primary outcome measures were the percentage of patients with stable or improved visual acuity (VA) and with stable or decreased central retinal thickness (CRT) at the last visit. Secondary outcome measure was the incidence of ocular and systemic complications.RESULTS:Recurrence was observed in 11 eyes (73.33%) over a mean follow-up of 57.33 months (range: 25–100). A mean number of injections administered was 5.60. VA improved or stabilized in 73.33% and deteriorated in 26.67% of eyes at the final visit. Mean CRT improved from 324.40 μm at baseline to 265.53 μm at final visit, which was statistically significant. Complications observed were ocular hypertension in one patient and thromboembolic event in another patient.CONCLUSIONS:IVB appears to be a safe and effective option to treat CNV and to preserve vision over a prolonged period. It cannot eliminate the risk of recurrent CNV indicating the need for more effective treatments to arrest this visually debilitating condition.

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“…There is a clear correlation between cerebral infarction and bevacizumab although the conclusion is based on individual cases. [ 7 ] However, the large-sample-based data analyses by Campbell et al . [ 8 9 ] indicated that the incidence of ischemic stroke was not significantly different between the bevacizumab treating group and control group.…”

Section: Discussionmentioning

confidence: 99%

Relief Effect of Bevacizumab on Severe Edema Induced by Re-irradiation in Brain Tumor Patients

Wang

Guan

et al. 2015

Chinese Medical Journal

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Acute stroke after intravitreal bevacizumab to treat choroidal neovascularization due to angioid streaks in pseudoxanthoma elasticum

Cited by 11 publications

References 19 publications

Pseudoxanthoma Elasticum: Successful Long-Term Management of Choroidal Neovascularization Secondary to Angioid Streaks With Pro Re Nata Intravitreal Bevacizumab Injections

Pseudoxanthoma Elasticum: Successful Long-Term Management of Choroidal Neovascularization Secondary to Angioid Streaks With Pro Re Nata Intravitreal Bevacizumab Injections

Intravitreal bevacizumab for choroidal neovascularization associated with angioid streaks: Long-term results

Relief Effect of Bevacizumab on Severe Edema Induced by Re-irradiation in Brain Tumor Patients

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