| 제목 |
Would intravitreal bevacizumab injection increase risk of cerebral infarction? |
| 소속 |
St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea, Department of Rehabilitation Medicin1, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea, Department of Ophthalmology and Visual Science2 |
| 저자 |
Seong Hoon Lim1*†, Jin-woo Kwon2, Donghyun Jee2, Won Jin Sung1 |
Purpose
There has been controversy concerning the possible association between intravitreal bevacizumab injection(IVB) injection and thromboembolic accidents. Some studies reported no association between IVB injection and stroke or myocardial infarction (MI). Several other studies have reported the possible association between IVB injection and thromboembolic accidents. The use of IVB for AMD has been increased with time for aged community. Thus, the relation between IVB and thromboembolic accidents should be uncovered.
Although previous studies have investigated the effects of IVB injection on cerebral infarction, the effects of IVB are still not fully understood. The aim of this study was to determine the effects of IVB on cerebral infarction. In a small-scale study, we identified possible new risk factors, providing a basis for future population-based studies.
Material and Methods
We retrospectively reviewed patients with AMD who received IVB injections for 1 year and determined the incidence of CI within 60 days after IVB injection to analyze the possible association between IVB and CI.
Results
Over a 12-month period, 263 patients were enrolled. Six patients (2.28%) were diagnosed with CI within 2 months after receiving an IVB injection. The average number of IVB injections over the 1-year period was 2.98 ± 1.58 and was not significantly different between the two groups. The total number of IVB injections per patient was 4.95 ± 3.31 and was not significantly different between the two groups (Table 1). The incidence of CI in patients 75–84 years of age was 6.38%. These results showed a higher incidence of patients with IVB injections than the results of previous epidemiological studies (0.13% for all age groups, 1.68% for patients 75–84 years of age). All CI occurred 21–53 days after the IVB injection (mean: 39.33 ± 14.65 days). Logistic regression analyses showed that age and a history of previous cerebral infarction were factors associated with cerebral infarction (p = 0.042 and p = 0.008, respectively; Table 2). However, the total number of IVB injections and the number of IVB injections over 1 year were not associated with cerebral infarction (Table 2).
Conclusions
Treatment with IVB may be an independent risk factor for cerebral infarction. Careful consideration by clinicians is necessary before administering IVB injections, especially in older patients or in patients with a previous history of cerebral infarction. These results are therefore useful for planning treatment strategies for patients with AMD, as well as for prevention of cerebral infarction. |
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