Hamadneh Tariq, Shehadeh Mohammad, Yasin Anas, Akkawi Mohammad, An MeiXia, Yamin Hasan, Azamtta Murad
Ophthalmology Department, The Third Affiliated Hospital of Southern Medical University, Guangzhou, CHN.
Ophthalmology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2021 Feb 22;13(2):e13488. doi: 10.7759/cureus.13488.
Given the role the vascular endothelial growth factor (VEGF) plays in controlling and preserving the integrity of the vascular endothelium intravitreal administration of anti-VEGF agents may affect the risk of thromboembolic events. This is particularly noticeable in patients who are at risk for atherosclerosis. Here, we present one of the first case reports of transient ischemic attack (TIA) together with hypoventilation secondary to aflibercept injection. A 63-year-old female suffered TIA together with hypoventilation about 12 hours after the third administration of intravitreal aflibercept, which is a VEGF inhibitor for diabetic macular edema (DME). Upon presentation, she was confused, had right-sided weakness and her respiratory rate was six breaths per minute, all of these resolved within the next 24 hours. The serum tests, cerebrospinal fluid (CSF) analysis, brain imaging, and carotid Doppler ultrasound were unremarkable. An ophthalmic exam revealed signs of bilateral proliferative diabetic retinopathy with left macular edema. Detailed reports of similar cases are lacking in the literature. Hypoventilation and thromboembolic could be possible side effects of aflibercept that necessitate more investigation.
鉴于血管内皮生长因子（VEGF）在控制和维持血管内皮完整性方面所起的作用，玻璃体内注射抗VEGF药物可能会影响血栓栓塞事件的风险。这在有动脉粥样硬化风险的患者中尤为明显。在此，我们呈现了首例因阿柏西普注射继发短暂性脑缺血发作（TIA）并伴有通气不足的病例报告。一名63岁女性在第三次玻璃体内注射阿柏西普（一种用于治疗糖尿病性黄斑水肿（DME）的VEGF抑制剂）约12小时后出现TIA并伴有通气不足。就诊时，她神志不清，右侧肢体无力，呼吸频率为每分钟6次，所有这些症状在接下来的24小时内均得到缓解。血清检查、脑脊液（CSF）分析、脑部成像和颈动脉多普勒超声检查均无异常。眼科检查发现双侧增殖性糖尿病视网膜病变伴左眼黄斑水肿的体征。文献中缺乏类似病例的详细报告。通气不足和血栓栓塞可能是阿柏西普的副作用，需要更多研究。
