Acute Intraocular Inflammation after Intravitreous Injections of Bevacizumab for Treatment of Neovascular Age-related Macular Degeneration
Received 29 October 2007; received in revised form 24 April 2008; accepted 2 May 2008. published online 31 July 2008.
Purpose
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.
Design
A retrospective case series.
Participants
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.
Main Outcome Measures
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.
Financial Disclosure(s)
The authors have no proprietary or commercial interest in any materials discussed in this article.
Available online: July 31, 2008.
1Medical Retina Unit, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
2Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
4Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore
Correspondence: Tien Y. Wong, PhD, FRANZCO, Professor of Ophthalmology University of Melbourne, Centre for Eye Research Australia, 32 Gisborne Street, East Melbourne, Australia 3002
Manuscript no. 2007-1402.
Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.
ABSTRACT