Non-arteritic anterior ischemic optic neuropathy (NA-AION) after intravitreal injection of bevacizumab (Avastin) for treatment of angoid streaks in pseudoxanthoma elasticum

Graefes Arch Clin Exp Ophthalmol. 2009 Dec;247(12):1707-10. doi: 10.1007/s00417-009-1184-5.


Background: To report a case of nonarteritic anterior ischemic optic neuropathy (NA-AION) following intravitreal injection of bevacizumab (Avastin).

Methods: Interventional case report with an 18-month follow-up.

Results: A 51-year-old male with pseudoxanthoma elasticum presented with NA-AION 2 weeks after treatment with intravitreal of bevazicumab (Avastin) for choroidal neovascularisation secondary to angioid streaks. Except from a small optic disc without cupping he did not show further risk factors.

Discussion: Risk of NA-AION should be taken into consideration when deciding for intravitreal application of drugs including anti-vascular endothelial growth factors (VEGF) agents like bevacizumab (Avastin) in the treatment of retinal vascular diseases.

Publication types

  • Case Reports

MeSH terms

  • Angiogenesis Inhibitors / adverse effects*
  • Angioid Streaks / diagnosis
  • Angioid Streaks / drug therapy*
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Humanized
  • Arteritis / chemically induced
  • Bevacizumab
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Optic Neuropathy, Ischemic / chemically induced*
  • Optic Neuropathy, Ischemic / diagnosis
  • Pseudoxanthoma Elasticum / complications*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity
  • Vitreous Body


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab