%0 Journal Article
%T Retrograde Amnesia and Disorientation After Intraocular Injection of Anti-vegf Agents - Retrograde Amnesia and Disorientation After Intraocular Injection of Anti-vegf Agents - Open Access Pub
%A Johannes Schr£żder
%A Matthias N. Ungerer
%A Peter-Wolfgang Meyer
%J OAP | Home | Journal of Neurological Research And Therapy | Open Access Pub
%D 2018
%X We present a case of a 77-year-old male patient who was treated in our outpatient clinic for memory disorders because of episodic confusion and retrograde amnesia. The patient reported having symptoms repeatedly following intraocular treatment with Anti-Vascular Endothelial Growth Factor Agents (Ranibizumab and Bevacizumab) as a treatment for wet macular degeneration. EEG showed a localized deceleration that intensified under prolonged voluntary hyperventilation. Symptoms resolved after the intraocular Anti-Vascular Endothelial Growth Factor treatment was stopped and anticonvulsive treatment with lamotrigine was begun. This case is important in that it describes a potential association between intraocular treatments with Anti-Vascular Endothelial Growth Factor Agents and seizures. Symptoms occurred in temporal correlation with intraocular treatment. Clinicians should be aware of this potential side effect on intraocular treatment with Anti-Vascular Endothelial Growth Factor Agents in patients with high risk for seizures. DOI10.14302/issn.2470-5020.jnrt-18-2258 Although late-onset idiopathic generalized epilepsy is very rare among elderly patients, epilepsy is a significant health care issue of the elderlypopulation 1, 2, 3. Important known risk factors for seizures in the elderly are cerebrovascular diseases, neurodegenerative disorders, tumors, traumatic head injuries, metabolic pathologies and toxins 4. Progressive cognitive decline including Alzheimer disease as well as microangiopathy are also associated with a higher risk for seizures 5,6. Ranibizumab and Bevacizumab are Anti-Vascular Endothelial Growth Factor Agents used in macular degeneration treatment 7. Studies have found increased serum levels of Bevacizumab after intravitreal application for as long as 2 weeks after injection, and have therefore assumed that it could cause systemic side-effects 8. Systemic side-effects are nevertheless considered to be rare 9. Generalized seizures have been reported as a side effect after intravenous administration of Bevacizumab in patients with metastatic colorectal cancer 10. A case of an 81-year-old female with tonic-clonic seizures following intravitreal application of Bevacizumab was reported in 2010 11. Intravitreal administration of Ranibizumabhas not been associated with significant serum concentrations 12. This is in line with a greater decrease of systemic Vascular Endothelial Growth Factor ¨C A level after intravitreous treatment with Bevacizumab compared to Ranibizumab 13. Vitreous half-life of 1.25 mg Bevacizumab (4.32 days) was found to be
%U https://www.openaccesspub.org/jnrt/article/830