Acute intraocular inflammation after intravitreous injections of bevacizumab for treatment of neovascular age-related macular degeneration.
OBJECTIVE
Bevacizumab is an inhibitor of vascular endothelial growth factor widely used as an "off-label" treatment of neovascular age-related macular degeneration (AMD), despite the lack of clinical trial data on efficacy or safety of this drug. We describe acute intraocular inflammation after intravitreous injection of bevacizumab for the treatment of neovascular AMD.


METHODS
A retrospective case series.


METHODS
Patients with neovascular AMD treated with intravitreous injection of bevacizumab from clinical practices in 2 states (Victoria and South Australia) in Australia.


METHODS
We retrospectively reviewed cases of acute intraocular inflammation after intravitreous injection of bevacizumab for the treatment of neovascular AMD.


METHODS
The detection and description of inflammation in a large cohort of patients.


RESULTS
There were 14 cases (11 women and 3 men), from a total of 1278 injections given. The mean age of patients was 83.7 years (range, 74-98). The majority had a prior injection of bevacizumab, with a mean number of injections of 2.7 (range, 1-6). Most patients presented within 24 hours of intravitreous injection, with rapid reduction in vision, but minimal discomfort. There were associated signs of ocular inflammation in the anterior and posterior segments of the eye. Visual acuity at presentation was substantially reduced compared with the preinjection acuity, although the vision rapidly improved with treatment over a period of 7-25 days toward preinjection visual acuity.


CONCLUSIONS
Intravitreous injection of bevacizumab for the treatment of neovascular AMD may be associated with acute intraocular inflammation. Differentiation from infectious endophthalmitis is important for appropriate management of this condition.
Wickremasinghe
Sanjeewa S
SS
Medical Retina Unit, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Michalova
Kira
K
Gilhotra
Jagjit
J
Guymer
Robyn H
RH
Harper
C Alex
CA
Wong
Tien Y
TY
Qureshi
Salmaan
S
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D009877:Endophthalmitis / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab