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Endophthalmitis risk low after bevacizumab or ranibizumab injection
Retina. 2008;28(10):1395-1399.
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The incidence of endophthalmitis after injection with either bevacizumab or ranibizumab is low, according to a study.
Overall incidence of endophthalmitis in a retrospective, consecutive, multicenter case series analysis was 0.02%, or about one case per 4,500 injections. Incidence of endophthalmitis was 0.02% per injection of Avastin (bevacizumab, Genentech) and 0.02% per injection of Lucentis (ranibizumab, Genentech).
A total of 12,585 injections of 1.25-mg bevacizumab and 14,230 injections of 0.5-mg ranibizumab were analyzed in the study. Three patients in the bevacizumab group and three patients in the ranibizumab group were diagnosed with infectious endophthalmitis.
"Four of these patients had culture-proven bacterial endophthalmitis, while the remaining two were culture-negative," the study authors said. Both of the culture-negative samples were in the ranibizumab group.
The causative bacteria discovered on culture were Streptococcus viridans (two cases), Streptococcus mitis and Staphylococcus epidermis.
All endophthalmitis patients self-reported symptoms within 5 days of the initial injection, and the clinical centers involved in the study routinely followed up with injection recipients to check for symptoms of endophthalmitis. The use of a follow-up phone call should have increased the capture rate and minimized reporting bias, meaning that the large sample size should adequately predict the true endophthalmitis rate, according to the study.