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

A severe systemic adverse event after an off-label procedure

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Abstract

To report the occurrence of acute stroke after intravitreal bevacizumab administration to treat choroidal neovascularization due to angioid streaks in a patient affected by pseudoxanthoma elasticum. A 54-year-old man with pseudoxanthoma elasticum had vision loss because of choroidal neovascularization due to angioid streaks. He underwent two intravitreal bevacizumab injections. Three days after the second procedure the patient was afflicted by acute stroke. Intravitreal injection of bevacizumab to treat choroidal neovascularization due to angioid streaks in pseudoxanthoma elasticum could lead to severe systemic adverse events.

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References

  1. Chassaing N, Martil L, Calvas P et al (2005) Pseudoxanthoma elasticum: a clinical, pathophysiological and genetic update including 11 novel ABCC6 mutations. J Med Genet 42(12):881–892

    Article  PubMed  CAS  Google Scholar 

  2. Gass JDM (1997) Angioid streaks. In: Stereoscopic Atlas of Macular Diseases. St. Louis, Mosby, 118–125

  3. Gass JDM (2003) Photo essay: “Comet” lesion: an ocular sign of pseudoxanthoma elasticum. Retina 23:729–730

    Article  PubMed  Google Scholar 

  4. Clarkson JG, Altman RD (1982) Angiod streaks. Surv Ophthalmol 26:235–246

    Article  PubMed  CAS  Google Scholar 

  5. Shields JA, Federman JL, Tomer TL, Annesley WH Jr (1975) Angioid streaks. I. Ophthalmoscopic variations and diagnostic problems. Br J Ophthalmol 59:257–266

    Article  PubMed  CAS  Google Scholar 

  6. Brancato R, Menchini U, Pece A, Davi G, Capoferri C (1978) Laser treatment of macular subretinal neovascularization in angioid streaks. Ophthalmologica 105:299–303

    Google Scholar 

  7. Browning AC, Chung AK, Ghanchi F et al (2005) Verteporfin photodynamic therapy of choroidal neovasularization in angioid streaks: one-year results of a prospective casa series. Ophthalmology 112:1227–1231

    Article  PubMed  Google Scholar 

  8. Roth DB, Estefanous M, Lewis H (2001) Macular translocation for subfoveal choroidal neovasularization in angioid streaks. Am J Ophthalmol 131:390–392

    Article  PubMed  CAS  Google Scholar 

  9. Neri P, Salvolini S, Mariotti C, Mercanti L, Celani S, Giovannini A (2009) Long-term control of choroidal neovascularisation secondary to angioid streaks treated with intravitreal bevacizumab (Avastin). Br J Ophthalmol 93(2):155–158

    Article  PubMed  CAS  Google Scholar 

  10. Myung JS, Bhatnagar P, Spaide RF et al (2010) Long-term outcomes of intravitreal antivascular endothelial growth factor for the management of choroidal neovascularization in pseudoxanthoma elasticum. Retina 30:748–755

    Article  PubMed  Google Scholar 

  11. Finger RP, Issa PC, Schmitz-Valckenberg S, Holz FG, Scholl HN (2011) Long-term effectiveness of intravitreal bevacizumab for choroidal neovascularization secondary to angioid streaks in pseudoxanthoma elasticum. Retina 31:1268–1278

    Article  PubMed  CAS  Google Scholar 

  12. Dafer RM, SChneck M, Friberg TR (2007) Intravitreal ranibizumab and bevacizumab: a review of risk. Semin Ophthalmol 22:201–204

    Article  PubMed  Google Scholar 

  13. Fung AE, Rosenfeld PJ, Reichel E (2006) The International Intravitreal Bevacizumab Safety Survey: using the internet to assess drug safety worldwide. Br J Ophthalmol 90:1344–1349

    Article  PubMed  CAS  Google Scholar 

  14. Bhatnagar P, Bailey Freund K, Spaide RF et al (2007) Intravitreal bevacizumab for the management of choroidal neovascularization in pseudoxanthoma elasticum. Retina 27:897–902

    Article  PubMed  Google Scholar 

  15. Rinaldi M, Dell’Omo R, Romano MR et al (2007) Intravitreal bevacizumab for choroidal neovascularization secondary to angioid streaks. Arch Ophthalmol 125(10):1422–1423

    Article  PubMed  Google Scholar 

  16. Van den Berg JS, Hennekam RC, Cruysberg JR et al (2000) Prevalence of symptomatic intracranial aneurysm and ischaemic stroke in pseudoxanthoma elasticum. Cerebrovasc Dis 10(4):315–319

    Article  PubMed  Google Scholar 

  17. Bashshur ZF, Haddad ZA, Schakal AR et al (2009) Intravitreal bevacizumab for treatment of neovascular age-related macular degeneration: the second year of a prospective study. Am J Ophthalmol 148(1):59–65

    Article  PubMed  CAS  Google Scholar 

  18. CATT Research Group (2011) Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med 364(20):1897–1908

    Article  Google Scholar 

  19. IVAN Study Investigators (2012) Ranibizumab versus bevacizumab to treat neovascular age-related macular degeneration: one-year findings from the IVAN randomized trial. Ophthalmology 119(7):1399–1411

    Article  Google Scholar 

  20. Curtis LH, Hammill BG, Schulman KA, Cousins SW (2010) Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration. Arch Ophthalmol 128(10):1273–1279

    Article  PubMed  Google Scholar 

  21. Wong TY, Liew G, Mitchell P (2007) Clinical update: new treatments for age-related macular degeneration. Lancet 370(9583):204–206

    Article  PubMed  Google Scholar 

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Correspondence to Gianluca Besozzi.

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Besozzi, G., Ferrara, A., Epifani, E. et al. Acute stroke after intravitreal bevacizumab to treat choroidal neovascularization due to angioid streaks in pseudoxanthoma elasticum. Int Ophthalmol 33, 181–183 (2013). https://doi.org/10.1007/s10792-012-9647-9

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  • DOI: https://doi.org/10.1007/s10792-012-9647-9

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