Herpetic epithelial keratitis after intravitreal injection of bevacizumab (avastin).
OBJECTIVE
To report a case of herpetic epithelial keratitis that developed after intravitreal bevacizumab (Avastin) injection.


METHODS
A 63-year-old man with diabetes with proliferative diabetic retinopathy and macular edema received intravitreal injection of bevacizumab (Avastin) in his right eye.


RESULTS
Three days after the injection, the patient presented with foreign body sensation, redness, tearing, photophobia, and decreased visual acuity in the right eye. The cornea showed an arborizing dendritic epithelial lesion with terminal bulb typical of herpes simplex virus (HSV) epithelial keratitis. HSV-DNA was detected in corneal scrapings using polymerase chain reaction. A diagnosis for herpes simplex epithelial keratitis was made. Topical acyclovir ointment therapy was initiated with good resolution of HSV signs and symptoms.


CONCLUSIONS
Herpes simplex epithelial keratitis can be a possible complication of intravitreal bevacizumab (Avastin) injection. To our knowledge, this case is the first report of herpetic epithelial keratitis after intravitreal bevacizumab (Avastin) injection.
Khalili
Mohammad Reza
MR
Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran. khalilimr@sums.ac.ir
Mehdizadeh
Morteza
M
Mehryar
Morsal
M
D000212:Acyclovir / Q000627:therapeutic use; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000627:therapeutic use; D000068258:Bevacizumab; D004279:DNA, Viral / Q000032:analysis; D003930:Diabetic Retinopathy / Q000188:drug therapy; D019573:Epithelium, Corneal / Q000187:drug effects / Q000473:pathology / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007267:Injections; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D004279:DNA, Viral; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000212:Acyclovir