Cargando…

Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition

PURPOSE: In this study, we report a case of branch retinal artery occlusion (BRAO) in the contralateral eye the day after aflibercept treatment during systemic heparin administration. OBSERVATIONS: A 63-year-old woman with diabetic macular edema underwent repeated intravitreal injection of anti-VEGF...

Descripción completa

Detalles Bibliográficos
Autores principales: Nakao, Shintaro, Yoshimitsu, Makoto, Kaizu, Yoshihiro, Wada, Iori, Yamaguchi, Muneo, Sonoda, Koh-Hei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726921/
https://www.ncbi.nlm.nih.gov/pubmed/31508535
http://dx.doi.org/10.1016/j.ajoc.2019.100549
_version_ 1783449176002002944
author Nakao, Shintaro
Yoshimitsu, Makoto
Kaizu, Yoshihiro
Wada, Iori
Yamaguchi, Muneo
Sonoda, Koh-Hei
author_facet Nakao, Shintaro
Yoshimitsu, Makoto
Kaizu, Yoshihiro
Wada, Iori
Yamaguchi, Muneo
Sonoda, Koh-Hei
author_sort Nakao, Shintaro
collection PubMed
description PURPOSE: In this study, we report a case of branch retinal artery occlusion (BRAO) in the contralateral eye the day after aflibercept treatment during systemic heparin administration. OBSERVATIONS: A 63-year-old woman with diabetic macular edema underwent repeated intravitreal injection of anti-VEGF drugs (0.5mg ranibizumab or 2mg aflibercept) for her left eye. The day after intravitreal injection of aflibercept, she presented with sudden painless blurred vision that was limited to the inferior visual field defect in the contralateral eye (right eye) during hemodialysis with the anti-coagulant heparin. Optical coherence tomography angiography (OCTA) showed decreased artery perfusion and the patient was diagnosed with contralateral BRAO. CONCLUSIONS: Previous in vitro and in vivo studies have reported that the Fc portion of anti-VEGF drugs activates platelets with heparin. Therefore, careful anti-VEGF drug selection may be necessary in cases with concomitant heparin treatment.
format Online
Article
Text
id pubmed-6726921
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-67269212019-09-10 Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition Nakao, Shintaro Yoshimitsu, Makoto Kaizu, Yoshihiro Wada, Iori Yamaguchi, Muneo Sonoda, Koh-Hei Am J Ophthalmol Case Rep Case Report PURPOSE: In this study, we report a case of branch retinal artery occlusion (BRAO) in the contralateral eye the day after aflibercept treatment during systemic heparin administration. OBSERVATIONS: A 63-year-old woman with diabetic macular edema underwent repeated intravitreal injection of anti-VEGF drugs (0.5mg ranibizumab or 2mg aflibercept) for her left eye. The day after intravitreal injection of aflibercept, she presented with sudden painless blurred vision that was limited to the inferior visual field defect in the contralateral eye (right eye) during hemodialysis with the anti-coagulant heparin. Optical coherence tomography angiography (OCTA) showed decreased artery perfusion and the patient was diagnosed with contralateral BRAO. CONCLUSIONS: Previous in vitro and in vivo studies have reported that the Fc portion of anti-VEGF drugs activates platelets with heparin. Therefore, careful anti-VEGF drug selection may be necessary in cases with concomitant heparin treatment. Elsevier 2019-08-28 /pmc/articles/PMC6726921/ /pubmed/31508535 http://dx.doi.org/10.1016/j.ajoc.2019.100549 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Nakao, Shintaro
Yoshimitsu, Makoto
Kaizu, Yoshihiro
Wada, Iori
Yamaguchi, Muneo
Sonoda, Koh-Hei
Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition
title Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition
title_full Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition
title_fullStr Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition
title_full_unstemmed Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition
title_short Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition
title_sort branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: possible contribution of a heparin-induced thrombocytopenia-like condition
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726921/
https://www.ncbi.nlm.nih.gov/pubmed/31508535
http://dx.doi.org/10.1016/j.ajoc.2019.100549
work_keys_str_mv AT nakaoshintaro branchretinalarteryocclusionintheuntreatedcontralateraleyefollowingafliberceptinjectionsduringheparintreatmentpossiblecontributionofaheparininducedthrombocytopenialikecondition
AT yoshimitsumakoto branchretinalarteryocclusionintheuntreatedcontralateraleyefollowingafliberceptinjectionsduringheparintreatmentpossiblecontributionofaheparininducedthrombocytopenialikecondition
AT kaizuyoshihiro branchretinalarteryocclusionintheuntreatedcontralateraleyefollowingafliberceptinjectionsduringheparintreatmentpossiblecontributionofaheparininducedthrombocytopenialikecondition
AT wadaiori branchretinalarteryocclusionintheuntreatedcontralateraleyefollowingafliberceptinjectionsduringheparintreatmentpossiblecontributionofaheparininducedthrombocytopenialikecondition
AT yamaguchimuneo branchretinalarteryocclusionintheuntreatedcontralateraleyefollowingafliberceptinjectionsduringheparintreatmentpossiblecontributionofaheparininducedthrombocytopenialikecondition
AT sonodakohhei branchretinalarteryocclusionintheuntreatedcontralateraleyefollowingafliberceptinjectionsduringheparintreatmentpossiblecontributionofaheparininducedthrombocytopenialikecondition