Abstract:

The use of intravitreal anti-vascular endothelial growth factor therapy is currently a standard of care for a variety of ophthalmological conditions. Whilst the systemic use of these agents in oncology is well known to induce a number of renal-related adverse effects such as worsening hypertension and proteinuria, the ability of local intravitreal injections to cause similar side effects has traditionally thought to be unlikely given the lower doses used. In this case report we describe an 88-year-old lady who developed a sudden worsening of her previously stable proteinuria with the use of bilateral intravitreal bevacizumab injections for diabetic macular oedema, with improvement in her proteinuria with reduction to unilateral therapy. This case report adds to the growing body of literature which suggests that local anti-VEGF therapy may have the potential to induce adverse systemic effects, and clinicians who care for these patients should remain vigilant to the development of potential renal related toxicity.