Secondary rhegmatogenous retinal detachment following intravitreal bevacizumab in patients with vitreous hemorrhage or tractional retinal detachment secondary to Eales' disease

To report the occurrence of secondary rhegmatogenous retinal detachment (RRD) after intravitreal bevacizumab injection in patients with Eales' disease. This is a retrospective, non-controlled, comparative case series. We reviewed 14 eyes of 14 patients with Eales' disease who had received pretreatment with intravitreal bevacizumab (1.25 mg/0.05 ml) and subsequently undergone a pars plana vitrectomy for non-resolving vitreous hemorrhage and/or tractional retinal detachment. Clinical records were reviewed. The primary outcome measure was the occurrence of secondary RRD after intravitreal bevacizumab injection. Four patients had developed secondary RRD, with retinal breaks that were localized to the base of tractional retinal bands, within 1 week of receiving intravitreal bevacizumab. On comparative analysis, median age of patients who had developed secondary RRD was 26.5 years, significantly less than the median age of 33.5 years in the rest (P = 0.022). Median post-operative best-corrected visual acuity (BCVA) in patients who developed secondary RRD was logMAR 0.7 (0.3-0.8), significantly worse than the BCVA of logMAR 0.3 (0.0-0.5) in the rest (P = 0.015). None of the patients who developed secondary RRD had a complete posterior vitreous detachment (PVD) at presentation. Intravitreal bevacizumab injections may be associated with the serious complication of secondary RRD in patients of Eales' disease within 7 days of injection.