Case of endophthalmitis following intravitreal injections of bevacizumab

PURPOSE 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.