Retinal vascular events after intravitreal bevacizumab

Purpose: To record retinal vascular events following intravitreal bevacizumab injection. Methods: Collaborative multi-centre retrospective case series. Results: Eight patients were documented to have central retinal artery occlusion (four patients), branch retinal artery occlusion, capillary occlusion, central retinal vein occlusion and branch retinal vein occlusion (one patient each) within 0-55 days (median 2 weeks) of intravitreal bevacizumab. All patients had several ocular and systemic risk factors for retinal vascular events: elevated intraocular pressure on discharge (four patients), pre-existent glaucoma (one patient), pre-existent ischaemic retinal vascular disorder (four patients), systemic hypertension (five patients), diabetes mellitus (three patients), coronary artery disease (four patients), carotid disease (three patients), smoking (two patients) and migraine (one patient). Conclusion: The retinal vascular events may be associated with the underlying ocular disease under treatment or with the underlying systemic disease, may be related to an increased intraocular pressure post-injection constraining further an already poor retinal perfusion, the vasoconstrictor effect of bevacizumab, or a combination of all three.