Intravitreal bevacizumab (Avastin) associated with secondary hyphaema in a case of proliferative sickle cell retinopathy

Babalola, O E

doi:10.1136/bcr.11.2009.2441

Cited by 15 publications

(11 citation statements)

References 7 publications

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“…Intravitreal bevacizumab can be used as a pre-surgical adjunctive agent to decrease the risk of intraoperative bleeding and facilitate dissection of sea fan neovascular structures [69][70][71]. Although preoperative bevacizumab may be efficient, secondary hyphaema, a few days post-injection, is a possible complication [72]. Cai et al recently described five eyes of five patients with PSR that were managed with intravitreal bevacizumab therapy over a 13-year period [73].…”

Section: Intravitreal Injection Of Anti-vascular Endothelial Growth Fmentioning

confidence: 99%

Sickle cell retinopathy. A focused review

Elsayed

Mura

Dhibi

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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Purpose To provide a focused review of sickle cell retinopathy in the light of recent advances in the pathogenesis, multimodal retinal imaging, management of the condition, and migration trends, which may lead to increased prevalence of the condition in the Western world. Methods Non-systematic focused literature review. Results Sickle retinopathy results from aggregation of abnormal hemoglobin in the red blood cells in the retinal microcirculation, leading to reduced deformability of the red blood cells, stagnant blood flow in the retinal precapillary arterioles, thrombosis, and ischemia. This may be precipitated by hypoxia, acidosis, and hyperosmolarity. Sickle retinopathy may result in sight threatening complications, such as paracentral middle maculopathy or sequelae of proliferative retinopathy, such as vitreous hemorrhage and retinal detachment. New imaging modalities, such as wide-field imaging and optical coherence tomography angiography, have revealed the microstructural features of sickle retinopathy, enabling earlier diagnosis. The vascular growth factor ANGPTL-4 has recently been identified as a potential mediator of progression to proliferative retinopathy and may represent a possible therapeutic target. Laser therapy should be considered for proliferative retinopathy in order to prevent visual loss; however, the evidence is not very strong. With recent development of wide-field imaging, targeted laser to ischemic retina may prove to be beneficial. Exact control of intraoperative intraocular pressure, including valved trocar vitrectomy systems, may improve the outcomes of vitreoretinal surgery for complications, such as vitreous hemorrhage and retinal detachment. Stem cell transplantation and gene therapy are potentially curative treatments, which may prevent retinopathy. Conclusions There is lack of evidence regarding the optimal management of sickle retinopathy. Further study is needed to determine if recent progress in the understanding of the pathophysiology and diagnosis of sickle retinopathy may translate into improved management and outcome.

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Section: Intravitreal Injection Of Anti-vascular Endothelial Growth Fmentioning

confidence: 99%

Sickle cell retinopathy. A focused review

Elsayed

Mura

Dhibi

et al. 2019

Graefes Arch Clin Exp Ophthalmol

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“…Bevacizumab, albeit efficient in preoperative injection, 80 was associated with significant secondary effects such as secondary hyphema few days postinjection in the eye of a PSCR patient with VH. 81 Clinical trials aiming to compare efficacy and safety of ranibizumab versus aflibercept, in patients with SCR versus patients with diabetic retinopathy, would be an asset.…”

Section: Current and Advanced Therapeutic Options For Scrmentioning

confidence: 99%

Sickle cell retinopathy: improving care with a multidisciplinary approach

Menaa¹,

Khan²,

Uzair³

et al. 2017

JMDH

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Sickle cell retinopathy (SCR) is the most representative ophthalmologic complication of sickle cell disease (SCD), a hemoglobinopathy affecting both adults and children. SCR presents a wide spectrum of manifestations and may even lead to irreversible vision loss if not properly diagnosed and treated at the earliest. Over the past decade, multidisciplinary research developments have focused upon systemic, genetic, and ocular risk factors of SCR, enabling the clinician to better diagnose and manage these patients. In addition, newer imaging and testing modalities, such as spectral domain-optical coherence tomography angiography, have resulted in the detection of subclinical retinopathy related to SCD. Innovative therapy includes intravitreal injection of an anti-vascular endothelial growth factor (eg, Lucentis® [ranibizumab] or Eylea® [aflibercept]) which appears comparatively safe and efficient, and may be combined with laser photocoagulation (LPC) for proliferative SCR. The effect of LPC alone does not significantly lead to the regression of advanced SCR, although it helps in avoiding hemorrhage and sight loss. This comprehensive article is based on 10-years retrospective (2007–2017) studies. It aims to present advances and recommendations in SCR theranostics while pointing out the requirement of combinatorial approaches for better management of SCR patients. To reach this goal, we identified and analyzed randomized original and review articles, clinical trials, non-randomized intervention studies, and observational studies using specified keywords in various databases (eg, Medline, Embase, Cochrane, ClinicalTrials.gov).

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“…His BCVA was improved from 20/40 to 20/20, the vitreous hemorrhage was resolved, and the neovascularization regressed, presenting no recurrence at the 6-month follow-up [ 20 ]. Contrary to Siqueira et al and Shaikh, Babalola reported no resolution of vitreous hemorrhage and development of hyphema after intravitreal injection of bevacizumab for sickle cell retinopathy in a 25-year-old male patient, while in the other eye regression of stage III sea fan neovascularization was remarked [ 21 ]. Our case is the first one, using intravitreal ranibizumab for the treatment of stage IV sickle cell retinopathy, showing promising results.…”

Section: Discussionmentioning

confidence: 98%

Intravitreal Ranibizumab for Stage IV Proliferative Sickle Cell Retinopathy: A First Case Report

Mitropoulos¹,

Chatziralli²,

Parikakis³

et al. 2014

Case Reports in Ophthalmological Medicine

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Purpose. To present the case of a 27-year-old male patient with stage IV proliferative sickle cell retinopathy, treated with one intravitreal injection of ranibizumab, showing regression of the neovascularization and no recurrence at the 9-month follow-up. Methods. A 27-year-old male patient presented with blurred vision and floaters in the right eye since three days. His best corrected visual acuity was 6/18. Ophthalmological examination and fluorescein angiography revealed proliferative sickle cell retinopathy stage IV with vitreous hemorrhage and sea fan neovascularization, as well as ischemic areas at the temporal periphery. Results. The patient was treated with one intravitreal injection of ranibizumab, presenting improvement in the visual acuity from 6/18 to 6/6, resolution of vitreous hemorrhage, and regression of the neovascularization. Additionally, he underwent scatter laser photocoagulation at the ischemic areas. At the 9-month follow-up there was no recurrence, while no adverse effects were noticed. Conclusions. Intravitreal ranibizumab may be a useful adjunct to laser photocoagulation in the management of proliferative sickle cell retinopathy and may permit some patients to avoid pars plana vitrectomy for vitreous hemorrhage.

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Intravitreal bevacizumab (Avastin) associated with secondary hyphaema in a case of proliferative sickle cell retinopathy

Cited by 15 publications

References 7 publications

Sickle cell retinopathy. A focused review

Sickle cell retinopathy. A focused review

Sickle cell retinopathy: improving care with a multidisciplinary approach

Intravitreal Ranibizumab for Stage IV Proliferative Sickle Cell Retinopathy: A First Case Report

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