Case of endophthalmitis following intravitreal injections of bevacizumab

Abstract

Shinya Komori1, Akira Sawada1, Tsutomu Oguni1, Kiyofumi Mochizuki1, Kiyofumi Ohkusu21Department of Ophthalmology, 2Department of Microbiology, Gifu University Graduate School of Medicine, Gifu, JapanPurpose: We report a case of infectious endophthalmitis that developed after the third intravitreal injection of bevacizumab. The endophthalmitis was caused by Staphylococcus epidermidis.Methods: Observational case series.Results: This was a case of a 77-year-old man who had received three intravitreal injections of bevacizumab and developed infectious endophthalmitis. Polymerase chain reaction of an aqueous humor sample showed that the endophthalmitis was caused by S. epidermidis. The patient received intravitreal ceftazidime and vancomycin, and subconjunctival injection of vancomycin. After the intravitreal injections he was treated with topical levofloxacin and cefmenoxime hydrochloride, and intravenous cefpirome. Subsequently, the ocular inflammation gradually decreased and his visual acuity remained at 30/200.Conclusions: Our findings indicate that endophthalmitis can develop after intravitreal bevacizumab injections. Polymerase chain reaction is useful for differentiation from sterile endophthalmitis.Keywords: endophthalmitis, bevacizumab, Staphylococcus, antibiotics