Vitrectomy does not Cure Bevacizumab Induced Uveitis

Non-infectious inflammation associated with intravitreal antivascular endothelial growth factor injections has been reported recently. Failure to recognize this sterile inflammation can result in unnecessary treatment for endophthalmitis. We describe a case of acute noninfective intraocular inflammation following the third intravitreal injection of bevacizumab for nonischemic central retinal vein occlusion-associated cystoid macular edema in a 74-year-old man who responded temporarily to repeated intravitreal antibiotics and vitrectomy. Prolonged use of systemic steroid (oral prednisolone monotherapy) resulted in resolution of the uveitis. No organisms could be demonstrated even on repeated aqueous and vitreous taps. Bevacizumab-induced uveitis is a rare event and its pathogenesis remains unclear. With the increasing use of bevacizumab, it is important to be aware of its potential to be associated with intraocular inflammation and to differentiate it from infective endophthalmitis.