Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition.
Branch retinal artery occlusion in the untreated contralateral eye following aflibercept injections during heparin treatment: Possible contribution of a heparin-induced thrombocytopenia-like condition.
复制标题
肝素治疗期间注射阿柏西普后，未经治疗的对侧眼出现视网膜分支动脉闭塞：可能是肝素诱导的血小板减少症样病症的原因。
DOI：
10.1016/j.ajoc.2019.100549
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Sonoda KH.
中科院分区：
文献类型：
--
作者：
Nakao S;Yoshimitsu M;Kaizu Y;Wada I;Yamaguchi M;Sonoda KH.
目的在这项研究中，我们报告一例分支视网膜动脉阻塞（BRAO）在对侧眼aflibercept治疗后的第二天，在全身heparinadministration.ObservationsA 63岁的女性糖尿病黄斑水肿进行了反复玻璃体内注射抗VEGF药物（0.5毫克雷珠单抗或2毫克aflibercept）为她的左眼。在玻璃体内注射aflibercept后第二天，患者在使用抗凝肝素进行血液透析期间出现突发无痛性视力模糊，仅限于对侧眼（右眼）的下视野缺损。光学相干断层扫描血管造影（OCTA）显示动脉灌注减少，患者被诊断为对侧BRAO.ConclusionsPreviousin vitroandin vivostudies报道，抗VEGF药物的Fc部分激活血小板与肝素。因此，在伴随肝素治疗的情况下，可能需要仔细选择抗VEGF药物。
PurposeIn 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.ObservationsA 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.ConclusionsPreviousin vitroandin vivostudies 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.