Incidence of Endophthalmitis Related to Intravitreal Injection of Bevacizumab and Ranibizumab

Abstract

The rate of endophthalmitis associated with intravitreal bevacizumab and ranibizumab is low, with an incidence of approximately 1 in 4,500 injections.

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

“…10,11 However, the reported rate in the recent studies tends to be lower than that in early trials. [10][11][12][13][14][15][16] The rate of endophthalmitis seems to be the same among different anti-VEGF agents, 12 different injection settings, 15 and different geographical locations. 17 Recent studies reported that endophthalmitis caused by Streptococcus species was significantly more frequent after intravitreal injection than after intraocular surgery.…”

Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom: incidence, features, risk factors, and outcomes

“…This rate is comparable to or better than other studies of endophthalmitis following intravitreal therapy and cataract surgery. 15,17,18,21,32,33,[35][36][37] As with endophthalmitis following cataract surgery, vitreous sampling achieved a higher organism yield rate compared with aqueous sampling. 28,32,33 However, as aqueous sampling yielded an organism that was not identified by vitreous sampling in two cases, it may be optimal to perform both vitreous and aqueous sampling in the event of PIAE in order to maximise the chance of identifying a causative pathogen.…”

“…16,17,22,41 More recently, larger studies have been published reporting risk factors for PIAE. Shah et al 42 reported a case control study of 23 cases of PIAE that did not find any of the variables they studied to be significant risk factors.…”

“…28 The incidence rate found in this study of 0.025% of PIAE is comparable to previous work that has quoted rates ranging from 0.02-0.1%. 9,10,12,[14][15][16][17][18]21,22 This is the largest prospective study to ascertain an incidence rate for PIAE in the UK population when intravitreal anti-VEGF is used to treat exudative ARMD.…”

“…[9][10][11][12][13] Following intravitreal injection of anti-VEGF, the incidence of endophthalmitis is thought to be low with rates of between 0.02 and 0.1% previously being reported. 9,10,12,[14][15][16][17][18][19][20][21][22] This is the first UK-wide population-based prospective study to determine the incidence and features of endophthalmitis following intravitreal injection of anti-VEGF therapy and to identify reversible risk factors for endophthalmitis so that reported incidence rates may be reduced.…”