TY - JOUR
T1 - Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment
T2 - Possible contribution of a heparin-induced thrombocytopenia-like condition
AU - Nakao, Shintaro
AU - Yoshimitsu, Makoto
AU - Kaizu, Yoshihiro
AU - Wada, Iori
AU - Yamaguchi, Muneo
AU - Sonoda, Koh Hei
N1 - Funding Information:
This study was supported by grants from JSPS KAKENHI , Grant-in-Aid for Scientific Research (C) No. 17K11456 (SN).
Publisher Copyright:
© 2019 The Authors
PY - 2019/12
Y1 - 2019/12
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ajoc.2019.100549
DO - 10.1016/j.ajoc.2019.100549
M3 - Article
AN - SCOPUS:85071600982
SN - 2451-9936
VL - 16
JO - American Journal of Ophthalmology Case Reports
JF - American Journal of Ophthalmology Case Reports
M1 - 100549
ER -
