The International Intravitreal Bevacizumab Safety Survey: using the internet to assess drug safety worldwide.
OBJECTIVE
Off-label intravitreal injections of bevacizumab (Avastin) have been given for the treatment of neovascular and exudative ocular diseases since May 2005. Since then, the use of intravitreal bevacizumab has spread worldwide, but the drug-related adverse events associated with its use have been reported only in a few retrospective reviews. The International Intravitreal Bevacizumab Safety Survey was initiated to gather timely information regarding adverse events from doctors around the world via the internet.


METHODS
An internet-based survey was designed to identify adverse events associated with intravitreal bevacizumab treatment. The survey web address was disseminated to the international vitreoretinal community via email. Rates of adverse events were calculated from participant responses.


RESULTS
70 centres from 12 countries reported on 7113 injections given to 5228 patients. Doctor-reported adverse events included corneal abrasion, lens injury, endophthalmitis, retinal detachment, inflammation or uveitis, cataract progression, acute vision loss, central retinal artery occlusion, subretinal haemorrhage, retinal pigment epithelium tears, blood pressure elevation, transient ischaemic attack, cerebrovascular accident and death. None of the adverse event rates exceeded 0.21%.


CONCLUSIONS
Intravitreal bevacizumab is being used globally for ocular diseases. Self-reporting of adverse events after intravitreal bevacizumab injections did not show an increased rate of potential drug-related ocular or systemic events. These short-term results suggest that intravitreal bevacizumab seems to be safe.
Fung
A E
AE
Pacific Eye Associates, 2100 Webster Street, Suite 214, San Francisco, CA 94115, USA. annefungmd@yahoo.com
Rosenfeld
P J
PJ
Reichel
E
E
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001766:Blindness / Q000139:chemically induced; D002386:Cataract / Q000139:chemically induced; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D005500:Follow-Up Studies; D019538:Health Care Surveys / Q000379:methods; D006801:Humans; D007267:Injections / Q000009:adverse effects; D007391:International Cooperation; D020407:Internet; D002546:Ischemic Attack, Transient / Q000139:chemically induced; D008268:Macular Degeneration / Q000188:drug therapy*; D057566:Self Report; D020521:Stroke / Q000139:chemically induced; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000139:chemically induced; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab