title: Severe intraocular inflammation after intravitreal injection of bevacizumab.
abstract: OBJECTIVE
  To report 5 cases of severe intraocular inflammation that developed after an intravitreal injection of the same lot of bevacizumab.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Patients treated with an intravitreal injection of bevacizumab (lot B3003B01).
  
  
  METHODS
  The clinical charts of 35 eyes of 35 consecutive patients who were treated with intravitreal injection of lot B3003B01 bevacizumab from December 18, 2008, through January 20, 2009, were reviewed.
  
  
  METHODS
  Incidence of intraocular inflammation, results of bacterial cultures, best-corrected visual acuity (BCVA), and endothelial cell density.
  
  
  RESULTS
  Five (14.3%) of the 35 cases had severe intraocular inflammation, and the inflammation had some characteristics of toxic anterior segment syndrome (TASS). Five of the 5 cases had a predominantly anterior chamber reaction, and 4 of the 5 cases were accompanied by hypopyon. Undiluted samples collected from both the aqueous and vitreous of the 5 cases were culture negative. The BCVA was 0.66+/-0.29 (mean+/-standard deviations) logarithm of the minimum angle resolution (logMAR) units, and the endothelial cell density was 2683.6+/-97.3/mm(2) before the intravitreal bevacizumab. At the final visit, the BCVA was 0.44+/-0.36 logMAR units, and the cell density was 2679.0+/-217.5/mm(2). These differences were not significant (P = 0.171 and 0.964).
  
  
  CONCLUSIONS
  These observations indicate that an intravitreal injection of bevacizumab can induce sterile endophthalmitis that has characteristics of TASS.
authors.affiliation: Department of Ophthalmology, Osaka Rosai Hospital, Sakai, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Sato
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Emi
authors.forename: Toshihide
authors.initials: T
authors.lastname: Ikeda
authors.forename: Hajime
authors.initials: H
authors.lastname: Bando
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sato
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Morita
authors.forename: Tomohito
authors.initials: T
authors.lastname: Oyagi
authors.forename: Kosaku
authors.initials: K
authors.lastname: Sawada
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; D002452:Cell Count; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D009877:Endophthalmitis / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012164:Retinal Diseases / Q000188:drug therapy*; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab