Neovascular membrane and pregnancy. Treatment with bevacizumab

Abstract

Clinical case

A female in her sixth month of pregnancy, with a history of refractive surgery, consulted due to a metamorphopsia and decrease in visual acuity in the right eye. A presumed ocular histoplasmosis syndrome (POHS) and a subfoveal choroidal neovascular membrane were observed in the fundoscopy. Two monthly doses of intravitreal bevacizumab were given after the labor, but the third dose was never infected as the patient became pregnant again. She subsequently had a spontaneous miscarriage.

Discussion

During pregnancy treatment with intravitreal bevacizumab during pregnancy is controversial as it may increase the risk of miscarriage during the first trimester.

Resumen

Caso clínico

Mujer en el sexto mes de gestación, con antecedentes de cirugía refractiva, que consulta por metamorfopsias y disminución de la agudeza visual en el ojo derecho. En la exploración se observa una membrana neovascular coroidea subfoveal asociada al síndrome de presunta histoplasmosis ocular (SPHO). Tras el parto se realiza tratamiento con dos dosis mensuales de bevacizumab intravítreo. La tercera dosis no se realiza por nuevo embarazo, observándose posteriormente aborto espontáneo sin causa conocida.

Discusión

El tratamiento con bevacizumab intravítreo durante el embarazo es controvertido, ya que es posible que aumente el riesgo del aborto espontáneo durante el primer trimestre.