Non- infectious inflammatory response Following Intravitreal Bevascizumab Injections:
 

A cluster of Cases in Two Centers

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Shiri Shulman MD (1,2), Omer Trivizki MD (2), Neta Negri RN (2), Michaela Goldstein MD (2)

(1) Ophthalmology Institute, Assuta Medical Centers

(2) Ophthalmology Division, Tel-Aviv medical Center

 

Purpose

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To present a cluster of seven uveitis cases that occurred after intravitreal Bevascizumab injections within a period of two weeks in two separate centers.

 

Methods

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A retrospective case series.Data was extracted from the medical records in both centers

 

Results

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Seven eyes of seven patients were included. All patiets had intravitreal Bevascizumab Injections within a period of two weeks in two separate hospitals. The drug was manufactured in the same compounding pharmacy.

 

The indication for the injection was NVAMD in six patients and macular edema associated with BRVO in one patient.The onset of symptoms was 0.9 days +-2.4 days.

The most common findings were anterior uveitis in all patients and vitritis in three patients. Non of the patients had hypopion.The mean visual acuity was 0.27+-1.28 logMAR before the injection, 0.38+- 1.41 at presentation (P=0.54 ) and 0.37+- 1.47 at the last follow up (P=0.41 compared to presentation).

 

All patients were treated with intensive topical steroids and antibiotic drops. The patients presenting with vitritis underwent a vitreus tap and intravitreal antibiotic injection. All cultures were negative.

 

The mean follow up was 85+-15 days. All patiens had no evidence of inflammation at the end of follow-up. Five patients had repeated bevascizumab injections after resolution of inflammation and non had a recurrent episode .

 

Conclusions 

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In our series of cases with non infectious uveitis after intravitreal bevascizumab injections inflammation resolved in all cases an visual acuity recovered.

This process may result from an immune reaction to the drug itself but may also result from a problem in the preparation or delivery process. This may explain our cluster of cases.

 

FINENCIAL DISCLOSURE – NONE