[Six cases of sterile endophthalmitis developed consecutively after intravitreal injection of bevacizumab].

PURPOSE

To report a series of 6 cases of sterile endophthalmitis that developed consecutively after an intravitreal injection of bevacizumab (IVB).

PATIENTS AND METHODS

On April 13 and 14, 2009, we performed IVB for consecutive 12 eyes of 12 patients in a sterile condition. Within two days after injection, blurred vision without ocular pain, anterior chamber inflammation, and vitreous opacity were developed in 6 of the eyes of 6 patients. Hypopyon was not observed in any patient. Anterior chamber fluid from each eye and all syringes of bevacizumab that have been separated from the same bottle of same lot number were sent for bacterial culture examination.

RESULTS

No bacterial colony was developed from the anterior chamber fluid of any of the patients nor from any of the syringes. Antibiotic treatment of all 6 patients was unsuccessful. The symptoms improved in all cases following treatment with topical corticosteroid within several days.

CONCLUSIONS

Both the clinical course and the results of bacterial culture, lead to the possibility that our patients developed sterile endophthalmitis rather than infectious endophthalmitis. The exact causes of the endophthalmitis were not identified in our cases, but similar events are reported by several institutions, endophthalmitis following IVB needs to be considered a possibility.