Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2011 Sep;2(3):314-8.
doi: 10.1159/000332830. Epub 2011 Sep 23.

Macular edema formation and deterioration of retinal function after intravitreal bevacizumab injection for proliferative diabetic retinopathy

Hisanori Imai  1 , Shigeru Honda, Yasutomo Tsukahara, Akira Negi
Affiliations
Case Reports

Macular edema formation and deterioration of retinal function after intravitreal bevacizumab injection for proliferative diabetic retinopathy

Hisanori Imai et al. Case Rep Ophthalmol. 2011 Sep.

Abstract

Purpose: To report a case of proliferative diabetic retinopathy (PDR) showing transient macular edema (ME) and deteriorated retinal function after intravitreal bevacizumab injection (IVB).

Methods and results: A 53-year-old man received IVB (1.25 mg/0.05 ml) in both eyes for the treatment of PDR. There was no treatment-related complication. However, he complained of photopsia in both eyes 6 h after the injection. Slit-lamp examination revealed mild cellular infiltrations (1+) in the anterior chamber in both eyes. Optical coherence tomography showed ME formation in the left eye. Both full-field and multifocal electroretinography (ERG) revealed the deterioration of all parameters in both eyes compared with pretreatment. The inflammation in the anterior segment and ME disappeared 1 day after the injection. ERG parameters were improved 9 days after the injection, except for the N1 and P1 amplitude of multifocal ERG in the left eye.

Conclusion: We propose that patients who undergo IVB should be carefully informed and followed up for possible complications including temporal ME formation and retinal function deterioration.

Keywords: Anti-vascular endothelial growth factor; Avastin; Bevacizumab; Diabetic retinopathy; Full-field electroretinography; Macular edema; Multifocal electroretinography; Optical coherence tomography.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Late-phase fluorescein angiography findings. a Leakages from neovascularizations on the disc and elsewhere were seen before IVB in both eyes. b Leakages from neovascularizations were reduced 9 days after the injection.
Fig. 2
Fig. 2
Upper panel: transition of retinal thickness and total macular volume in OCT. Lower panel: transition of the horizontal line and the color map image of retinal thickness in OCT. Before the injection, OCT findings showed normal macular appearances in both eyes. The retinal thickness and total macular volume in the left eye were increased 6 h after the injection. OCT findings in the left eye improved after 1 day and were kept normal after that. OCT findings in the right eye were kept normal during the follow-up period.
Fig. 3
Fig. 3
Transition of ERG parameters. Upper panel: transition of full-field bright-flash ERG. Lower panel: transition of multifocal ERG at 3 central rings of 103 hexagon analysis. In both methods, all ERG parameters worsened 6 h after the injection and improved with time, except for the N1 and P1 amplitudes of the left eye.
See this image and copyright information in PMC

References

    1. Arevalo JF, Wu L, Sanchez JG, et al. Intravitreal bevacizumab (avastin) for proliferative diabetic retinopathy: 6-months follow-up. Eye. 2009;23:117–123. - PubMed
    1. Ishikawa K, Honda S, Tsukahara Y, Negi A. Preferable use of intravitreal bevacizumab as a pretreatment of vitrectomy for severe proliferative diabetic retinopathy. Eye. 2009;23:108–111. - PubMed
    1. Modarres M, Nazari H, Falavarjani KG, Naseripour M, Hashemi M, Parvaresh MM. Intravitreal injection of bevacizumab before vitrectomy for proliferative diabetic retinopathy. Eur J Ophthalmol. 2009;19:848–852. - PubMed
    1. Arevalo JF, Maia M, Flynn HW, Jr, Saravia M, Avery RL, Wu L, Eid Farah M, DJ Pieramici, MH Berrocal, JG Sanchez. Tractional retinal detachment following intravitreal bevacizumab (Avastin) in patients with severe proliferative diabetic retinopathy. Br J Ophthalmol. 2008;92:213–216. - PubMed
    1. Jonas JB, Schmidbauer M, Rensch F. Progression of tractional retinal detachment following intravitreal bevacizumab. Acta Ophthalmol. 2009;87:571–572. - PubMed

Publication types