Query: Worried About Stroke

We received the following comment:

“I have had the exact treatment and result as anonymous. I had two Visudyne - the second left a hole in my vision. I had three Lucentis with good results for six months. Vision started to get wavy again and I had a fourth Lucentis this week. I am just 55 but worried about stroke. During injection my blood pressure shot up and my pulse was high and I turned hot pink?"

I think the reaction during the injection was more anxiety than anything else since I doubt that the Lucentis could have reached the bloodstream that quickly or had such a rapid effect. Another possibility could have been an allergic reaction to one of the drops or anesthetic given before the injection. Any hives or itching would support an allergic reaction.

We all worry about stroke but there is no definite evidence that it is increased with the use of intraocular Lucentis or Avastin for that matter. We know that intravenous Avastin causes an increased risk of stroke but that is at three hundred times the dose that is given into the eye. The intravenous Avastin is also given every two weeks in patients with metastatic colon cancer instead of every month or six weeks. The best guess is that these drugs, when used in the eye, can increase the risk of stroke, but that increase in the risk is minimal.

The person who left the comment should get his/her blood pressure checked. I can’t tell is he still has good vision in both or just one eye. It sounds like thought, that the Lucentis is keeping the vision good. I think if there is future evidence of leakage or fluid, I would keep getting the injections. Your doctor should monitor your blood pressure and pulse and try to keep you as calm as possible.