TITLE:
Intravitreal Injection of Bevacizumab Induced TMA: A Case Report
AUTHORS:
Nada Zagdouni, Mohamed Amine Khalfaoui, Benyounès Ramdani
KEYWORDS:
Vascular Endothelial Growth Factor (VEGF), Thrombotic Microangiopathy (TMA), Bevacizumab, Renal Toxicity, Intravitreal Injection
JOURNAL NAME:
Open Journal of Nephrology,
Vol.15 No.3,
July
25,
2025
ABSTRACT: The use of vascular endothelial growth factor (VEGF) inhibitors, particularly anti-VEGF agents like Bevacizumab, has become a cornerstone in the treatment of proliferative diabetic retinopathy and diabetic macular edema. While systemic renal side effects of these agents are well-documented, emerging evidence suggests that intravitreal administration may also be associated with significant renal risks. We report the case of a 32-year-old male with a 25-year history of type 1 diabetes who developed thrombotic microangiopathy (TMA) following intravitreal Bevacizumab injections. Diagnostic evaluations ruled out other causes, leading to a diagnosis of drug-induced TMA. Treatment included corticosteroids and plasma exchange, but renal function did not recover, necessitating hemodialysis. This case underscores the critical need for renal monitoring in patients receiving anti-VEGF therapy, particularly those with preexisting renal impairment, to mitigate the risk of serious renal complications.