Injection site ischemia and inflammation after intravitreal bevacizumab.
BACKGROUND
Bevacizumab is a monoclonal antibody to vascular endothelial growth factor (VEGF) used in the treatment of a variety of ocular conditions. It is known to exert an inhibitory effect on new vessels but has not previously been documented to affect mature vascular beds.


METHODS
The authors present an uncommon side effect of intravitreal bevacizumab, consisting of inflammation and transient nonperfusion of conjunctival, episcleral, and scleral vessels surrounding the injection site.


RESULTS
Possible mechanisms of this complication, including ischemia and inflammation, are considered.


CONCLUSIONS
The possibility of this complication should be recognized by clinicians treating patients with intravitreal bevacizumab, and measures should be taken to limit drug reflux at the injection site.
From the *Institute of Ophthalmology, University College London, London, United Kingdom; and †Moorfields Eye Hospital, London, United Kingdom.
Nikolaos D
ND
Georgakarakos
Paul
P
Sullivan
Jonathan
J
Dowler