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Observations placeholder

Visual hallucinations after intravitreal injection of bevacizumab in vascular age-related macular degeneration

Identifier

019939

Type of Spiritual Experience

Hallucination

Number of hallucinations: 1

Background

Bevacizumab, sold under the trade name Avastin, is an angiogenesis inhibitor, a drug that slows the growth of new blood vessels.

Bevacizumab is a recombinant humanized monoclonal antibody that blocks angiogenesis by inhibiting vascular endothelial growth factor A (VEGF-A).[2] VEGF-A is a chemical signal that stimulates angiogenesis in a variety of diseases, especially in cancer. Bevacizumab was the first clinically available angiogenesis inhibitor in the United States.]

Bevacizumab was approved by the U.S. Food and Drug Administration (FDA) for certain metastatic cancers. It received its first approval in 2004, for combination use with standard chemotherapy for metastatic colon cancer.  It has since been approved for use in certain lung cancers, renal cancers, ovarian cancers, and glioblastoma multiforme of the brain. It had been approved for breast cancer, but that approval was withdrawn when later studies showed no evidence of effectiveness

A description of the experience

Am J Ophthalmol. 2007 Jan;143(1):169-70. Epub 2006 Sep 7.

Visual hallucinations after intravitreal injection of bevacizumab in vascular age-related macular degeneration.

Meyer CH1, Mennel S, Hörle S, Schmidt JC.

  • 1Department of Ophthalmology, Philipps University, Robert-Koch-Strasse 4, 35037 Marburg, Germany. meyer_eye@yahoo.com

Abstract

PURPOSE:

To describe transient structured visual hallucinations in a patient with vascular age-related macular degeneration (AMD), following an intravitreal Avastin-injection.

DESIGN:

Interventional case reports.

METHODS:

A fully alert 83-year-old woman with disciform scar right eye (OD) and occult choroidal neovascularization (CNV) left eye (OS) experienced a progressive visual loss to 20/800 OD and 20/400 OS. A coherent 84-year-old woman with occult CNV both eyes (OU) experienced decreased vision of 20/800 OU. After both patients gave informed consent, an uneventful intravitreal injection of 1.25 mg Avastin was performed in the left eyes.

RESULTS:

One day and three days after an uneventful intravitreal injection both patients experienced structured hallucinations including trees, faces, and water for approximately 15 to 30 minutes.

CONCLUSIONS:

We report a typical symptoms of Charles-Bonnet syndrome (CBS) in patients with severe AMD after intravitreal Avastin-injections. The reduced retinal edema and realignment of the photoreceptors may promote the release phenomenon and trigger hallucinatory episodes.

Comment in

  • Charles Bonnet syndrome (visual hallucinations) after intravitreal avastin injection for age-related macular degeneration. [Am J Ophthalmol. 2007]

PMID:

17188061

The source of the experience

PubMed

Concepts, symbols and science items

Concepts

Symbols

Science Items

Activities and commonsteps

Commonsteps

References