Nguyen Chan, Giaconi JoAnn A
Stein Eye Institute, UCLA, Los Angeles, CA, USA.
Greater Los Angeles VA Healthcare Center, Los Angeles, CA, USA.
Am J Ophthalmol Case Rep. 2020 Oct 17;20:100968. doi: 10.1016/j.ajoc.2020.100968. eCollection 2020 Dec.
To describe the clinical presentation and ocular manifestations of intravitreal bortezomib.
Retrospective chart review of five patients who inadvertently received intravitreal injection of bortezomib, instead of bevacizumab, showed that all patients presented hyperacutely within 24-72 hours of the injection with pain and severe vision loss. Examination revealed a fibrinous anterior uveitis, corneal edema, and choroidal effusion associated with a shallow anterior chamber and secondary angle closure glaucoma. Significant vitritis was notably absent. Severe retinal vascular attenuation and optic atrophy, and sometimes even retinal infarction or detachment, followed. Four of the five patients rapidly progressed to no light perception vision. Vitreous gram stain and cultures were negative in all eyes.
Intravitreal bortezomib is severely toxic to the eye. Special safeguards should be instituted for the dispensing of intravitreal medications.
描述玻璃体内注射硼替佐米的临床表现和眼部表现。
对5例无意中接受了玻璃体内注射硼替佐米而非贝伐单抗的患者进行回顾性病历审查，结果显示所有患者在注射后24至72小时内出现超急性疼痛和严重视力丧失。检查发现纤维蛋白性前葡萄膜炎、角膜水肿和脉络膜积液，伴有前房变浅和继发性房角关闭性青光眼。明显没有显著的玻璃体炎。随后出现严重的视网膜血管变细和视神经萎缩，有时甚至出现视网膜梗死或脱离。5例患者中有4例迅速进展至无光感视力。所有眼的玻璃体革兰氏染色和培养均为阴性。
玻璃体内注射硼替佐米对眼睛具有严重毒性。应制定特殊的安全措施以分发玻璃体内用药。
