title: Evaluation of safety for bilateral same-day intravitreal injections of antivascular endothelial growth factor therapy.
abstract: OBJECTIVE
  To explore the incidence of complications after bilateral same-day intravitreal injections of antivascular endothelial growth factor pharmacotherapies in this retrospective interventional case series.
  
  
  METHODS
  An electronic review of billing records was performed to identify all bilateral same-day intravitreal antivascular endothelial growth factor injections performed within a single group retina practice between January 6, 2006 and June 1, 2009. The charts were reviewed to identify the complications of endophthalmitis, intraocular inflammation, retinal tear, and retinal detachment.
  
  
  RESULTS
  A total of 1,534 bilateral intravitreal injections (326 bevacizumab and 1,208 ranibizumab: 3,068 injections total) were performed in 367 patients. Three complications were identified. Two cases of unilateral culture-proven endophthalmitis occurred after bilateral intravitreal ranibizumab, and one case of unilateral acute intraocular inflammation occurred after bilateral intravitreal bevacizumab. In all three of these eyes, visual acuity returned to its preinjection level. No cases of retinal tear or retinal detachment were identified. The incidence of culture-proven endophthalmitis was 0.065%, and the incidence of acute intraocular inflammation was 0.033%.
  
  
  CONCLUSIONS
  The complication rates after bilateral same-day intravitreal antivascular endothelial growth factor injections seem to be similar to those after unilateral injections. Severe acute intraocular inflammation can occur unilaterally after same-day bilateral injections of bevacizumab.
authors.affiliation: Vitreous, Retina, and Macula Consultants of New York, New York, New York 10022, USA.
authors.forename: Luiz H
authors.initials: LH
authors.lastname: Lima
authors.forename: Sandrine A
authors.initials: SA
authors.lastname: Zweifel
authors.forename: Michael
authors.initials: M
authors.lastname: Engelbert
authors.forename: John A
authors.initials: JA
authors.lastname: Sorenson
authors.forename: Jason S
authors.initials: JS
authors.lastname: Slakter
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Cooney
authors.forename: James M
authors.initials: JM
authors.lastname: Klancnik
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Yannuzzi
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
mesh_terms: 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; D009877:Endophthalmitis / Q000453:epidemiology / Q000209:etiology*; D015818:Eye Infections, Bacterial / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D015994:Incidence; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy; D008297:Male; D000069579:Ranibizumab; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000453:epidemiology / Q000209:etiology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D034363:Viridans Streptococci / Q000302:isolation & purification; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab