Safety of repeat intravitreal injections of bevacizumab versus ranibizumab: our experience after 2,000 injections

Retina. 2009 Mar;29(3):313-8. doi: 10.1097/IAE.0b013e31819a5f98.


Purpose: To compare the safety of repeat intravitreal injections of bevacizumab versus ranibizumab performed on a large series of patients during the past 2 years period of time.

Methods: Four hundred fifty patients receiving 2,000 injections (1,275 bevacizumab and 725 ranibizumab) were studied retrospectively. Injections performed in a usual examination room under the standard sterile conditions. Follow-up varied from 3 to 24 months.

Results: Serious ocular adverse events were uncommon. Only one patient developed retinal detachment (0.05%). Most common procedure-related ocular adverse event was injection-site redness (64.75%). Postoperative subconjuctival hemorrhage occurred after 200 (10%) injections. Patients receiving aspirin treatment were more prone to have subconjuctival hemorrhage (P = 0.0002). Most common drug-related ocular adverse event was uveitis (1.90%), which was treated successfully and lasted no >12 days. There was no statistically significant difference between the patients treated with bevacizumab or ranibizumab regarding the noted adverse events (P > 0.5%).

Conclusion: Multiple intravitreal injections of bevacizumab or ranibizumab were both well tolerated and safe. Performing injections on a usual examination room proved safe. Injection-site redness, subconjuctival hemorrhage, and uveitis were the most common ocular adverse events. Aspirin treatment was a risk factor for the development of subconjuctival hemorrhage.

Publication types

  • Comparative Study

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Dose-Response Relationship, Drug
  • Drug-Related Side Effects and Adverse Reactions
  • Follow-Up Studies
  • Humans
  • Injections / statistics & numerical data
  • Ranibizumab
  • Retina / drug effects*
  • Retina / pathology
  • Retinal Diseases / drug therapy*
  • Retinal Diseases / pathology
  • Retrospective Studies
  • Time Factors
  • Vascular Endothelial Growth Factor A
  • Vitreous Body


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Ranibizumab