Intravitreal Bevacizumab for Proliferative Sickle Retinopathy: A Case Series

2017 ◽  
Vol 2 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Cindy X. Cai ◽  
Marguerite O. Linz ◽  
Adrienne W. Scott
Keyword(s):  
Sickle Cell ◽  
Large Scale ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Beta Thalassemia ◽  
Intravitreal Bevacizumab Injection ◽  
Initial Injection ◽  
Sea Fan ◽  
Recurrent Vitreous Hemorrhage

Purpose: To report outcomes of intravitreal bevacizumab therapy for proliferative sickle retinopathy (PSR). Methods: A retrospective, interventional case series. Five eyes of 5 patients with PSR were managed with intravitreal bevacizumab therapy over a 13-year period at a single institution. Results: Four patients had sickle cell-hemoglobin SC disease and 1 had sickle cell-beta thalassemia disease. Four of the patients treated with intravitreal bevacizumab injection were treated for recurrent vitreous hemorrhage and 1 was treated for new peripheral sea fan neovascularization. In those patients treated for vitreous hemorrhage, there was improvement in visual acuity as early as 2 weeks after treatment. Only 2 of the patients had documented recurrent vitreous hemorrhage during the period of follow-up after the initial injection. In 1 patient, the vitreous hemorrhage did not recur until 13 months after the injection. All patients showed an anatomic response to intravitreal bevacizumab therapy with partial regression of the peripheral sea fan neovascularization. All patients tolerated the injections without any complications. Conclusions: Intravitreal bevacizumab injections appear to be well tolerated and may be an effective treatment of PSR. Regression of peripheral sea fan neovascularization and decreased duration of vitreous hemorrhage may be observed. Large-scale randomized controlled trials are needed to further clarify the role of bevacizumab in PSR.

scholarly journals Recurrent Vitreous Hemorrhage from an Optic Nerve Retinal Arterial Macroaneurysm

2017 ◽  
Vol 8 (3) ◽  
pp. 503-509 ◽  
Author(s):  
Jessica F. Yang ◽  
Kamal Kishore
Keyword(s):  
Optic Nerve ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Retinal Arterial Macroaneurysm ◽  
The Third ◽  
Intravitreal Bevacizumab Injection ◽  
Long Duration ◽  
Pars Plana ◽  
Recurrent Vitreous Hemorrhage

Objective: To report a case of recurrent vitreous hemorrhage from an optic nerve retinal arterial macroaneurysm (ONRAM) successfully treated with intraoperative endolaser. Patient and Methods: A 92-year-old woman on oral aspirin and warfarin anticoagulation for atrial fibrillation developed three episodes of dense vitreous hemorrhage from an ONRAM. Due to failure of the vitreous hemorrhage to clear spontaneously, a total of three pars plana vitrectomy (PPV) procedures were performed along with a 1.25-mg intravitreal bevacizumab injection after the third episode of hemorrhage. During the third PPV procedure, a 25-gauge 532-nm green diode laser endoprobe was used to deliver low-power (100 mW) and long-duration (500 ms) laser spots directly on the ONRAM to induce intraoperative shrinkage of the ONRAM. Results: After the endolaser treatment, the macroaneurysm showed involution due to fibrosis without any adverse effects on retinal circulation or visual field defect. No recurrence of vitreous hemorrhage was noted after 2 years of follow-up. Conclusion: Oral anticoagulant use may have been responsible for the atypical clinical course in our patient. Laser photocoagulation, including intraoperative endolaser photocoagulation, may be considered in selected cases of symptomatic ONRAMs.

ROLE OF INTRAVITREAL BEVACIZUMAB (AVASTIN) INJECTED AT THE END OF DIABETIC VITRECTOMY IN PREVENTING POSTOPERATIVE RECURRENT VITREOUS HEMORRHAGE

Retina ◽  
2010 ◽  
Vol 30 (10) ◽  
pp. 1646-1650 ◽  
Author(s):  
Rizwan A Cheema ◽  
Javed Mushtaq ◽  
Wajeeha Al-Khars ◽  
Essam Al-Askar ◽  
Maheera A Cheema
Keyword(s):  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Diabetic Vitrectomy ◽  
Recurrent Vitreous Hemorrhage

scholarly journals Immediate Effect of Intravitreal Bevacizumab Injection on Intraocular Pressure

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Rabeeah Zafar ◽  
Amna Rizwan ◽  
Badar-ud-din Ather Naeem ◽  
Asfandyar Asghar ◽  
Naila Obaid
Keyword(s):  
Intraocular Pressure ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
P Value ◽  
Diabetic Patients ◽  
Vascular Endothelial ◽  
Post Injection ◽  
Intravitreal Bevacizumab Injection ◽  
Applanation Tonometer ◽  
Endothelial Growth Factor

Purpose:  To determine the immediate effect of intravitreal Bevacizumab on intraocular pressure (IOP) in eyes with retinal vascular disorders. Study Design:  Interventional case series. Place and Duration of Study:  Ophthalmology Department, Fauji Foundation Hospital, Rawalpindi, from January 2019to July 2019. Methods:  One hundred and thirty one patients were included in this study using non probability consecutive sampling. IOP was measured before intravitreal injection (baseline) and at 5 and 30 minutes post-injection. Descriptive statistics were obtained using SPSS version 21.0. Results:  One hundred and thirty one eyes of 131 patients were observed for IOP change after intra vitreal injection of Bevacizumab. Among them 23 (18%) were males and 108 (82.4%) were females. Mean age was 57.57 ± 13.09 years. Mean IOP at baseline was 16.16 ± 2.52 mmHg. At 5 minutes after injection, 108 eyes (82.4%) had raised IOP, maximum IOP recorded was 44 mmHg. There was a statistically significant correlation between IOP at baseline and 5 minutes with p = 0.005 (≤0.05). At 30 minutes, 94 eyes (71.7%) had IOP fallen back to normal. Statistically, an insignificant correlation was present between IOP at baseline and 30 minutes (p = 0.081) post-injection. IOP rise was not significantly correlated to gender, age, hypertension and asthma at any interval (p value > 0.05). However, IOP rise was significantly correlated in diabetic patients at 30 minutes. Conclusion:  IOP elevation has been observed after intravitreal bevacizumab in immediate post-injection period which warrants the monitoring of IOP in this critical period to avoid serious blinding complications. Key Words:  Bevacizumab, Vascular endothelial growth factor, Intraocular pressure, Goldmann applanation tonometer.

Surgical Retrieval of an Intraocular Needle Following Intravitreal Bevacizumab Injection

2019 ◽  
Vol 3 (4) ◽  
pp. 252-254
Author(s):  
Mariam Mathai ◽  
Joshua D. Levinson ◽  
Aziz A. Khanifar ◽  
Lindsay M. Smithen
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Intravitreal Injection ◽  
Intravitreal Bevacizumab ◽  
Vitreous Cavity ◽  
Surgical Removal ◽  
Intravitreal Bevacizumab Injection ◽  
Initial Injection ◽  
Pars Plana ◽  
23 Gauge

Purpose: The purpose of this case report is to describe a case of iatrogenic intraocular foreign body due to a fractured 30-gauge needle following intravitreal injection of bevacizumab. Methods: A case report is presented. Results: The patient presented with a 30-gauge needle in the vitreous cavity after receiving an intravitreal injection of bevacizumab for diabetic macular edema. Bilateral eye shields were placed to reduce movement of the foreign body and decrease the risk of injury to the lens or retina. The needle was successfully removed via a combination of 23-gauge pars plana vitrectomy and removal of the foreign body via a transscleral approach through the initial injection site. Visual acuity improved to 20/25 2 months after surgery. Conclusions: We present the successful preoperative management and surgical removal of a needle fragment from the vitreous cavity after the needle fractured during intravitreal injection.

scholarly journals Use of an automated pyrosequencing technique for confirmation of Sickle Cell Disease

2019 ◽  
Author(s):  
CC Martino ◽  
CS Alencar ◽  
P Loureiro ◽  
AB Carneiro-Proietti ◽  
CA Máximo ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
High Performance ◽  
Large Scale ◽  
Clinical Care ◽  
Beta Thalassemia ◽  
Cell Disease ◽  
Hemoglobin S ◽  
Hemoglobin C ◽  
Confirmatory Assay

ABSTRACTBackgroundThe diagnosis of sickle cell disease (SCD) is made by hemoglobin assays such as high-performance liquid chromatography (HPLC), isoelectric focusing and cellulose acetate or citrate agar electrophoresis. These assays are easy to perform and used in large-scale newborn screening in many countries. These tests however may not easily differentiate Sβ0 thalassemia from SS or identify other hemoglobin variants, and in this case, hemoglobin (HBB) gene sequencing may be necessary.ObjectivesTo develop a high throughput DNA based confirmatory assay for SCD and to detect mutations in the HBB gene.MethodsWe developed an automated pyrosequencing technique (PyS) based on QIAGEN technology (Hilden, Germany) to detect homozygous or heterozygous hemoglobin S mutations as well as hemoglobin C mutations. The technique was tested on 2,748 samples from patients enrolled in a multi-center SCD cohort in Brazil. Patients were previously tested using HPLC to diagnose SCD as part of routine clinical care. Any subjects with discrepant results between HPLC and PyS or with heterozygous hemoglobin S detected had Sanger sequencing of the HBB gene.ResultsWe identified 168 samples with discrepant results between HPLC and PyS and 100 with concordant HPLC and PyS= heterozygous S, which would suggest Sβ-thalassemia or other hemoglobin S variants. The PyS assay correctly identified 1906 (98.7%) of the 1930 HbSS and 628 (98.7%) of the 636 HbSC samples. Of the 179 remaining samples, PyS correctly indicated S heterozygosis in 165 (92.2%). Of the 165 heterozygous S samples confirmed by Sanger as consistent with Sβ thalassemia genotype, 84 samples were classified as Sβ0 thalassemia and 81 as Sβ+ thalassemia. The most frequent beta thalassemia mutations of Sβ0 and Sβ+ were HBB: c.118C>T (Gln40Stop) and HBB c.92 + 6T> C, respectively.DiscussionThe PyS proved to be satisfactory for large-scale confirmatory testing of hemoglobin mutation. Moreover, with this study we were able to describe the most common β+ and β0 mutations in SCD patients with Sβ-thalassemia in a large multi-institutional SCD cohort in Brazil.

Can an Intraoperative Bevacizumab Injection Prevent Recurrent Postvitrectomy Diabetic Vitreous Hemorrhage?

2009 ◽  
Vol 19 (4) ◽  
pp. 618-621 ◽  
Author(s):  
Mario R. Romano ◽  
Syed Khurshid Gibran ◽  
Joaquin Marticorena ◽  
David Wong ◽  
Henrich Heimann
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Diabetic Patients ◽  
Intravitreal Bevacizumab Injection ◽  
Pars Plana ◽  
Grade 3 ◽  
Bevacizumab Injection

Purpose To evaluate the recurrence of vitreous hemorrhage (VH) in patients treated with intravitreal bevacizumab (IVB) injection (2.5 mg/0.1 mL) intraoperatively at the end of vitrectomy for treatment of diabetic nonclearing VH. Methods A prospective pilot study of 30 eyes of 28 consecutive diabetic patients who underwent pars plana vitrectomy and IVB injection intraoperatively at the end of vitrectomy was performed. The amount of VH was graded with slit lamp biomicroscopy by three masked retinal specialists from grade 0 to grade 3. Main outcome measures were rate of recurrence of the VH, improvement in visual acuity, incidence of cataract formation, and postoperative complications through a follow-up of 6 months. Results The percentage of severe recurrent VH with no fundus details (grade 3) was 7%, 13%, 27%, and 30%, respectively, at 7 days and 1-, 3-, and 6-month follow-up. At 6-month follow-up, the best-corrected visual acuity improved from 1.00 to 0.4 logMAR (p=0.01) in 21 out of 30 eyes (70%). Nine out 20 (40%) phakic patients developed cataract during the follow-up period, and 7 (31%) of them underwent cataract surgery. Conclusions The study suggests that intravitreal bevacizumab injection cannot prevent rebleeding in eyes undergoing pars plana vitrectomy for treatment of diabetic vitreous hemorrhage.

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