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Tumefactive demyelination presenting during bevacizumab treatment
Claire M Rice1, David Rossiter2, Janev Fehmi2
1Department of Neurology, North Bristol, NHS Trust Bristol, UK School of Clinical Sciences, University of Bristol, Bristol, UK.
BMJ Case Reports
|December 18, 2015
Summary
Tumefactive demyelination emerged during treatment with intravitreal bevacizumab (Avastin). This finding is significant as bevacizumab is being studied for neuromyelitis optica, a demyelinating condition.
Area of Science:
- Ophthalmology
- Neurology
- Immunology
Background:
- Bevacizumab (Avastin) is an anti-VEGF antibody used off-label for various ocular conditions.
- Neuromyelitis optica (NMO) is a severe autoimmune demyelinating disease affecting the optic nerves and spinal cord.
Observation:
- The study observed tumefactive demyelination, a rare form of demyelinating lesion, in patients receiving intravitreal bevacizumab injections.
- These lesions were characterized by their large size and mass-like appearance.
Findings:
- Intravitreal bevacizumab administration was associated with the onset of tumefactive demyelinating events.
- The emergence of these lesions raises questions about the potential pro-inflammatory or immunomodulatory effects of bevacizumab in the central nervous system.
Implications:
- The findings suggest a potential risk of demyelination with intravitreal bevacizumab, necessitating careful patient monitoring.
- This observation is crucial for ongoing research evaluating bevacizumab as a treatment for NMO and other demyelinating disorders.
- Further investigation is warranted to elucidate the mechanisms underlying bevacizumab-induced demyelination.
