Photopsias during Systemic Bevacizumab Therapy

Background. The authors describe a case of recurrent photopsias in a 56-year-old woman following repeat treatments with systemic intravenous bevacizumab for stage IV ovarian cancer. To our knowledge, this is the first report of photopsias following systemic bevacizumab treatments in a patient with a normal eye exam. Case Presentation. A 56-year-old Caucasian female complained of onset of floaters and flashes in the temporal peripheral field of the right eye 1 day after receiving intravenous of 30 g of 25 mg/mL of systemic bevacizumab for treatment of stage IV ovarian cancer. Ophthalmic examination, including dilated fundus exam, spectral domain optical coherence tomography (SD-OCT) of the optic nerve head, and enhanced depth imaging SD-OCT of the macula, revealed no significant abnormalities. Possible mechanisms are reviewed. Conclusion. We propose that patients who undergo intravenous bevacizumab treatments are questioned for any ocular symptoms and that more systematic evaluations of retinal nerve fiber layer and choroidal effects are obtained in those patients who are on long-term treatment at high doses.