Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara, Shogoin, Sakyo, Kyoto 606-8507, Japan.
Retina. 2010 Mar;30(3):485-90. doi: 10.1097/IAE.0b013e3181bd2d51.
The purpose of this study was to report 14 consecutive cases of endophthalmitis after intravitreal injection of bevacizumab (Avastin; Roche, Basel, Switzerland) obtained from a single batch.
One vial of bevacizumab (100 mg/4 mL) was divided into 20 sterile injections and kept at 4 degrees C before use. Bevacizumab (1.25 mg/0.05 mL) was injected intravitreally into 19 eyes of 15 patients to treat macular edema or choroidal neovascularization. All treatments were performed within 1 week of the bevacizumab, which was from a single batch, being aliquotted into the 20 doses.
Of the 19 eyes, 14 showed moderate to severe ocular inflammation immediately after injection. Cultures of aqueous humor and vitreous from 5 eyes were negative for bacteria and fungi. Eyes with moderate inflammation received topical or systemic antibiotics and steroid treatment. Five eyes with severe inflammation underwent pars plana vitrectomy because of dense vitreous opacity. Visual acuity returned to preendophthalmitis levels in 12 eyes but had decreased in 2 eyes at 1 month after the injection.
Intravitreal injection of bevacizumab can cause sterile endophthalmitis. Most inflammation occurred within a few days after the intravitreous injection of the bevacizumab, but treatment with antibiotics, steroids, and/or vitrectomy was effective, and the prognosis was good in most cases.
本研究报告了 14 例连续使用同一批次贝伐单抗（罗氏制药，巴塞尔，瑞士）行玻璃体腔注射后发生眼内炎的病例。
将一瓶贝伐单抗（100mg/4ml）分为 20 份无菌注射液，使用前置于 4°C。15 例患者的 19 只眼因黄斑水肿或脉络膜新生血管化行玻璃体腔内注射 1.25mg/0.05ml 贝伐单抗。所有治疗均在贝伐单抗分装成 20 份后 1 周内进行。
19 只眼中 14 只在注射后立即出现中度至重度眼内炎症。5 只眼的房水和玻璃体液培养均未检出细菌和真菌。中度炎症的眼接受局部或全身抗生素和皮质类固醇治疗。5 只重度炎症的眼因玻璃体高度混浊行玻璃体切除术。12 只眼的视力恢复到眼内炎前水平，但在注射后 1 个月有 2 只眼视力下降。
玻璃体腔注射贝伐单抗可引起无菌性眼内炎。大多数炎症发生在玻璃体腔注射贝伐单抗后几天内，但抗生素、皮质类固醇和/或玻璃体切除术治疗有效，大多数情况下预后良好。
