Weinstein Orly, Abu Tailakh Muhammad, Lifshitz Tova, Novack Victor, Levy Jaime
Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel.
Ministry of Health, Israel.
Eur J Ophthalmol. 2020 Jan;30(1):66-71. doi: 10.1177/1120672118823128. Epub 2019 Jan 8.
Systemic complications of intravitreal anti-vascular endothelial growth factor agents are relatively uncommon but highly significant.
: To assess the risk for thromboembolic events following intravitreal bevacizumab injection in neovascular age-related macular degeneration patients by a large population-based study. : To analyze the association between injection frequency and the risk for thromboembolic events, the time interval between the injection and the thromboembolic events, and the influence of chronic diseases on complications rate.
A retrospective cohort study.
Consecutive neovascular age-related macular degeneration patients receiving intravitreal bevacizumab at Soroka University Medical Center from December 2005 to December 2013 were included. Thromboembolic events analyzed included acute coronary syndrome, acute myocardial infarction, stroke, deep vein thrombosis, and pulmonary embolism. The thromboembolic event rate was compared 2 years prior and 2 years after the initial intravitreal bevacizumab injection.
A total of 2102 patients were included. Acute coronary syndrome and stroke rate were higher 2 years after intravitreal bevacizumab (p = 0.03 and p = 0.01, respectively). No statistical significant difference was found for the rest of thromboembolic events. Patients older than 80 years and patients receiving less than six intravitreal bevacizumab injections were more likely to experience stroke. Patients with known cardiovascular risk factors before starting injections did not develop significant more thromboembolic events.
In our study population, patients treated with intravitreal bevacizumab were significantly more likely to experience stroke during 2 years after first injection.
玻璃体内注射抗血管内皮生长因子药物的全身并发症相对少见，但影响重大。
通过一项基于大样本人群的研究，评估新生血管性年龄相关性黄斑变性患者玻璃体内注射贝伐单抗后发生血栓栓塞事件的风险。分析注射频率与血栓栓塞事件风险、注射与血栓栓塞事件之间的时间间隔以及慢性病对并发症发生率的影响。
一项回顾性队列研究。
纳入2005年12月至2013年12月在索罗卡大学医学中心接受玻璃体内贝伐单抗治疗的连续性新生血管性年龄相关性黄斑变性患者。分析的血栓栓塞事件包括急性冠状动脉综合征、急性心肌梗死、中风、深静脉血栓形成和肺栓塞。比较首次玻璃体内注射贝伐单抗前2年和后2年的血栓栓塞事件发生率。
共纳入2102例患者。玻璃体内注射贝伐单抗后2年，急性冠状动脉综合征和中风发生率较高（分别为p = 0.03和p = ）。其余血栓栓塞事件未发现统计学显著差异。80岁以上患者和接受玻璃体内贝伐单抗注射少于6次的患者更易发生中风。开始注射前已知有心血管危险因素的患者发生的血栓栓塞事件并未显著增多。
在我们的研究人群中，接受玻璃体内贝伐单抗治疗的患者在首次注射后2年内发生中风的可能性显著更高。
