S Bevacizumab
Ruptured retinal arterial macroaneurysms with multilevel retinal haemorrhages: case reportA 50-year-old man developed ruptured retinal arterial macroaneurysms (RAM) with multilevel retinal haemorrhages during treatment with bevacizumab [Avastin].The man's optical coherence tomography (OCT) of the right eye showed cystoid macular oedema for which he received intravitreal bevacizumab (1.25 mg/0.05 cc). His retinal examinations also revealed multiple RAMs with evidence of a small retinal haemorrhage surrounding the RAM. He reported seeing "a central black spot" in the field of vision, that was noticed almost immediately after the intravitreal injection. A ruptured RAM along the inferotemporal arcade with resultant sub-internal limiting membrane, subretinal, and intraretinal bleed were revealed on a retinal examination and the findings were confirmed on OCT. Intravitreal bevacizumab was repeated as his cystoid macular oedema was persistent. His best corrected visual acuity was maintained at 20/200 and the retinal and subretinal haemorrhages were resolving, on final follow-up, 10 months after the rupture of the RAM [not all outcomes stated].Author comment: "Intravitreal bevacizumab was administered for the treatment of macular edema, following which there was a rupture of a preexisting RAM with multilevel retinal hemorrhages." Nakhwa CP, et al.