Incidence and characteristics of acute intraocular inflammation after intravitreal injection of bevacizumab: a retrospective cohort study1

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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.

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