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Transient Ischemic Attack and Hypoventilation 12 Hours After Intra-vitreal Aflibercept Injection

Given the role the vascular endothelial growth factor (VEGF) plays in controlling and preserving the integrity of the vascular endothelium intravitreal administration of anti-VEGF agents may affect the risk of thromboembolic events. This is particularly noticeable in patients who are at risk for ath...

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Autores principales: Hamadneh, Tariq, Shehadeh, Mohammad, Yasin, Anas, Akkawi, Mohammad, An, MeiXia, Yamin, Hasan, Azamtta, Murad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990083/
https://www.ncbi.nlm.nih.gov/pubmed/33777575
http://dx.doi.org/10.7759/cureus.13488
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author Hamadneh, Tariq
Shehadeh, Mohammad
Yasin, Anas
Akkawi, Mohammad
An, MeiXia
Yamin, Hasan
Azamtta, Murad
author_facet Hamadneh, Tariq
Shehadeh, Mohammad
Yasin, Anas
Akkawi, Mohammad
An, MeiXia
Yamin, Hasan
Azamtta, Murad
author_sort Hamadneh, Tariq
collection PubMed
description Given the role the vascular endothelial growth factor (VEGF) plays in controlling and preserving the integrity of the vascular endothelium intravitreal administration of anti-VEGF agents may affect the risk of thromboembolic events. This is particularly noticeable in patients who are at risk for atherosclerosis. Here, we present one of the first case reports of transient ischemic attack (TIA) together with hypoventilation secondary to aflibercept injection. A 63-year-old female suffered TIA together with hypoventilation about 12 hours after the third administration of intravitreal aflibercept, which is a VEGF inhibitor for diabetic macular edema (DME). Upon presentation, she was confused, had right-sided weakness and her respiratory rate was six breaths per minute, all of these resolved within the next 24 hours. The serum tests, cerebrospinal fluid (CSF) analysis, brain imaging, and carotid Doppler ultrasound were unremarkable. An ophthalmic exam revealed signs of bilateral proliferative diabetic retinopathy with left macular edema. Detailed reports of similar cases are lacking in the literature. Hypoventilation and thromboembolic could be possible side effects of aflibercept that necessitate more investigation.
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spelling pubmed-79900832021-03-26 Transient Ischemic Attack and Hypoventilation 12 Hours After Intra-vitreal Aflibercept Injection Hamadneh, Tariq Shehadeh, Mohammad Yasin, Anas Akkawi, Mohammad An, MeiXia Yamin, Hasan Azamtta, Murad Cureus Internal Medicine Given the role the vascular endothelial growth factor (VEGF) plays in controlling and preserving the integrity of the vascular endothelium intravitreal administration of anti-VEGF agents may affect the risk of thromboembolic events. This is particularly noticeable in patients who are at risk for atherosclerosis. Here, we present one of the first case reports of transient ischemic attack (TIA) together with hypoventilation secondary to aflibercept injection. A 63-year-old female suffered TIA together with hypoventilation about 12 hours after the third administration of intravitreal aflibercept, which is a VEGF inhibitor for diabetic macular edema (DME). Upon presentation, she was confused, had right-sided weakness and her respiratory rate was six breaths per minute, all of these resolved within the next 24 hours. The serum tests, cerebrospinal fluid (CSF) analysis, brain imaging, and carotid Doppler ultrasound were unremarkable. An ophthalmic exam revealed signs of bilateral proliferative diabetic retinopathy with left macular edema. Detailed reports of similar cases are lacking in the literature. Hypoventilation and thromboembolic could be possible side effects of aflibercept that necessitate more investigation. Cureus 2021-02-22 /pmc/articles/PMC7990083/ /pubmed/33777575 http://dx.doi.org/10.7759/cureus.13488 Text en Copyright © 2021, Hamadneh et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Hamadneh, Tariq
Shehadeh, Mohammad
Yasin, Anas
Akkawi, Mohammad
An, MeiXia
Yamin, Hasan
Azamtta, Murad
Transient Ischemic Attack and Hypoventilation 12 Hours After Intra-vitreal Aflibercept Injection
title Transient Ischemic Attack and Hypoventilation 12 Hours After Intra-vitreal Aflibercept Injection
title_full Transient Ischemic Attack and Hypoventilation 12 Hours After Intra-vitreal Aflibercept Injection
title_fullStr Transient Ischemic Attack and Hypoventilation 12 Hours After Intra-vitreal Aflibercept Injection
title_full_unstemmed Transient Ischemic Attack and Hypoventilation 12 Hours After Intra-vitreal Aflibercept Injection
title_short Transient Ischemic Attack and Hypoventilation 12 Hours After Intra-vitreal Aflibercept Injection
title_sort transient ischemic attack and hypoventilation 12 hours after intra-vitreal aflibercept injection
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990083/
https://www.ncbi.nlm.nih.gov/pubmed/33777575
http://dx.doi.org/10.7759/cureus.13488
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