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. 2024 May 5;44(1):216.
doi: 10.1007/s10792-024-03134-5.

Clinical features, management, and outcomes of patients with sterile endophthalmitis associated with intravitreal bevacizumab injection: retrospective case series

Ulviye Kivrak  1   2 , Aysu Karatay Arsan  3 , Güzide Akçay  3 , Muhammed Nurullah Bulut  3 , Hatice Selen Kanar  3 , Aynur Oflaz Hacısalihoğlu  3 , Şaban Şimşek  3
Affiliations

Clinical features, management, and outcomes of patients with sterile endophthalmitis associated with intravitreal bevacizumab injection: retrospective case series

Ulviye Kivrak et al. Int Ophthalmol. .

Abstract

Purpose: To evaluate clinical features, treatment protocol, outcomes, and complications that developed in this case series of 24 patients who had consecutive sterile endophthalmitis after intravitreal bevacizumab (IVB) injection.

Methods: In this retrospective case series, IVB was repackaged in individual aliquots from the three batches that were used on the same day. IVB was injected into 26 eyes of 26 patients due to diabetic macular edema, age-related macular degeneration, and branch retinal vein occlusion. All patients had intraocular inflammation. Patients were divided into two groups severe and moderate inflammation according to the intraocular inflammation. The medical records of all patients were reviewed. At each follow-up visit, the complete ophthalmologic examination was performed, including best corrected visual acuity (BCVA), intraocular pressure, biomicroscopy, and posterior fundus examination.

Results: Twenty-four of 26 patients were included in the study. Two patients were excluded from this study since they didn't come to follow-up visits. The mean BCVA was 1.00 ± 0.52 Log MAR units before IVB. At the final visit, the BCVA was 1.04 ± 0.47 Log MAR units. These differences were not significant (p = 0.58). Of the 24 eyes, 16 eyes had severe, and 8 eyes had moderate intraocular inflammation. Eleven eyes in the severe inflammation group underwent pars plana vitrectomy due to intense vitreous opacity. Smear, culture results, and polymerase chain reaction results were negative.

Conclusion: Sterile endophthalmitis may occur after IVB injection. Differential diagnosis of sterile endophthalmitis from infective endophthalmitis is crucial to adjust the appropriate treatment and prevent long-term complications due to unnecessary treatment.

Keywords: Bevacizumab; Complications; Intravitreal injection; Risk factors; Sterile endophthalmitis.

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References

    1. Yang JC, Haworth L, Sherry RM, Hwu P, Schwartzentruber DJ, Topalian SL et al (2003) A randomized trial of bevacizumab, an anti-vascular endothelial growth factor antibody, for metastatic renal cancer. N Engl J Med 349:427–434. https://doi.org/10.1056/NEJMoa021491 - DOI - PubMed - PMC
    1. Michels S, Rosenfeld PJ, Puliafito CA, Marcus EN, Venkatraman AS (2005) Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration twelve-week results of an uncontrolled open-label clinical study. Ophthalmology 112:1035–1047. https://doi.org/10.1016/j.ophtha.2005.02.007 - DOI - PubMed
    1. Wu L, Arevalo JF, Roca JA, Maia M, Berrocal MH, Rodriguez FJ et al (2008) Comparison of two doses of intravitreal bevacizumab (Avastin) for treatment of macular edema secondary to branch retinal vein occlusion: results from the Pan-American collaborative retina study group at 6 months of follow-up. Retina 28:212–219. https://doi.org/10.1097/IAE.0b013e3181619bee - DOI - PubMed
    1. Song JH, Byeon SH, Lee SC, Koh HJ, Kwon OW (2008) Short-term safety and efficacy of a single intravitreal bevacizumab injection for the management of polypoidal choroidal vasculopathy. Ophthalmologica 223:85–92. https://doi.org/10.1159/000175312 - DOI - PubMed
    1. Glassman AR, Wells JA 3rd, Josic K, Maguire MG, Antoszyk AN, Baker C et al (2020) Five-year outcomes after initial aflibercept, bevacizumab, or ranibizumab treatment for diabetic macular edema (Protocol T extension study). Ophthalmology 127(9):1201–1210. https://doi.org/10.1016/j.ophtha.2020.03.021 - DOI - PubMed

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