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Incidence and characteristics of acute intraocular inflammation after intravitreal injection of bevacizumab: a retrospective cohort study

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      Abstract

      Objective: To determine the incidence and characteristics of acute intraocular inflammation after intravitreal bevacizumab injections from a tertiary care retinal practice.
      Design: Retrospective cohort study.
      Participants: A consecutive series of patients who had received bevacizumab injections performed by a single surgeon.
      Methods: We reviewed the records of all patients with severe anterior chamber inflammation and (or) vitritis after bevacizumab injections.
      Results: A total of 693 bevacizumab injections were performed on 193 eyes of 173 patients between June 2006 and March 2008. There were a total of 9 cases of acute intraocular inflammation for an incidence of 1.30% (95% CI: 0.69%–2.47%). All patients had a worse visual acuity at the end of follow-up than on injection day. The mean loss of vision was 6.1 lines of Snellen visual acuity; one patient developed inflammation-induced glaucoma which required surgical intervention.
      Conclusions: Intravitreal injection of bevacizumab is associated with a low but significant risk of acute intraocular inflammation and may result in significant visual loss.

      Résumé

      Objet: Établissement de l’incidence et des caractéristiques de l’inflammation oculaire aiguë après injections intravitréennes de bévacizumab administrées dans une pratique de soins tertiaires pour la rétine.
      Nature: Étude rétrospective de cohorte.
      Participants: Examen des dossiers d’une série de patients consécutifs qui ont reçu des injections de bévacizumab administrées par un seul chirurgien.
      Methodes: Nous avons examiné les dossiers de tous les patients qui avaient une sévère inflammation de la chambre intérieure et (ou) un vitritis après des injections de bévacizumab.
      Résultats: En tout, 693 injections de bévacizumab ont été administrées dans 193 yeux de 173 patients entre les mois de juin 2006 et mars 2008. On a note 9 cas d’inflammation oculaire aiguë pour une incidence de 1,30 % (intervalle de confiance de 95 %: 0,69 %–2,47 %). L’acuité visuelle de tous les patients etait pire à la fin du suivi qu’au moment des injections. En moyenne, la perte de vision était de 6,1 lignes d’acuité visuelle de Snellen; un patient avait développé un glaucome induit par une inflammation, qui avait requis une intervention chirurgicale.
      Conclusions: L’injection intravitréenne de bévacizumab est associée à un risque faible mais significatif d’inflammation intraoculaire aiguë et peut entraîner une perte significative de la vue.

      Keywords

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      References

        • Wu L
        • Martinez-Castellanos MA
        • Quiroz-Mercado H
        • et al.
        Twelve-month safety of intravitreal injections of bevacizumab (Avastin): results of the Pan-American Collaborative Retina Study Group (PACORES).
        Graefes Arch Clin Exp Ophthalmol. 2008; 246: 81-87
        • Fung AE
        • Rosenfeld PJ
        • Reichel E
        The International Intravitreal Bevacizumab Safety Survey: using the internet to assess drug safety worldwide.
        Br J Ophthalmol. 2006; 90: 1344-1349
        • Ladas ID
        • Karagiannis DA
        • Rouvas AA
        • Kotsolis AI
        • Liotsou A
        • Vergados I
        Safety of repeat intravitreal injections of bevacizumab versus ranibizumab: our experience after 2,000 injections.
        Retina. 2009; 29: 313-318
        • Shima C
        • Sakaguchi H
        • Gomi F
        • et al.
        Complications in patients after intravitreal injection of bevacizumab.
        Acta Ophthalmol. 2008; 86: 372-376
        • Wickremasinghe SS
        • Michalova K
        • Gilhotra J
        • et al.
        Acute intraocular inflammation after intravitreous injections of bev-acizumab for treatment of neovascular age-related macular degeneration.
        Ophthalmology. 2008; 115: 1911-1915
        • Georgopoulos M
        • Polak K
        • Prager F
        • Prunte C
        • Schmidt-Erfurth U
        Characteristics of severe intraocular inflammation following intravitreal injection of bevacizumab (Avastin).
        Br J Ophthalmol. 2009; 93: 457-462
      1. Genentech. Reports of Intraocular Inflammatory Reactions After Intravitreal Injection with AVASTIN; 2008.

        • Fielden M
        • Nelson B
        • Williams G
        • Ells A
        • Anand J
        • Kherani A
        Acute intraocular inflammation following intravitreal injection of bevacizumab-a cluster of cases.
        in: Paper presented at the Canadian Ophthalmology Society Annual Conference and Exhibition, Toronto2009
        • Hall R
        • Lodha N
        • Mitchell P
        • Williams G
        • Kherani A
        Incidence of ocular complications following intravitreal bevacizu-mab (Avastin) injections.
        in: Paper presented at the Canadian Ophthalmology Society Annual Conference and Exhibition, Toronto2009
        • Holland S
        • Ma P
        • Maberley D
        • et al.
        Outbreak of acute intraocular inflammation after bevacizumab intravitreal injection: an epidemiological investigation.
        in: Paper presented at the Canadian Ophthalmology Society Annual Conference and Exhibition, Toronto2009
        • Wilson E
        Probable inference, the law of succession, and statistical inference.
        J Am Stat Assoc. 1927; 22: 209-212
        • Canadian Ophthalmology Society
        TASS/ID Task Force Hotline. 2009 (Available)