Infectious endophthalmitis after intravitreal injection of antiangiogenic agents

Retina. 2009 May;29(5):601-5. doi: 10.1097/IAE.0b013e31819d2591.


Purpose: To evaluate the rate of infectious endophthalmitis associated with intravitreal injection of bevacizumab, ranibizumab, and pegaptanib sodium.

Methods: A retrospective review of patients who received intravitreal injections of bevacizumab, ranibizumab, and pegaptanib sodium was undertaken. Cases of clinical diagnoses of endophthalmitis or suspected endophthalmitis resulting from intravitreal injection were identified and reviewed. From these data, the risk per injection was estimated.

Results: Three patients developed endophthalmitis after the intravitreal injection. The risk per injection was 0.00077 (0.077%). The rate of endophthalmitis was 1 per 1,291 injections.

Conclusion: A similar risk of endophthalmitis per injection compared with some trials was obtained in this study. Although no definite risk factors could be identified, intravitreal injections performed by nonretina specialist physicians may be a risk factor for the development of endophthalmitis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal, Humanized
  • Aptamers, Nucleotide / adverse effects
  • Bevacizumab
  • Ceftazidime / therapeutic use
  • Drug Therapy, Combination
  • Endophthalmitis / etiology*
  • Eye Infections / etiology*
  • Female
  • Humans
  • Injections / adverse effects*
  • Male
  • Ranibizumab
  • Retrospective Studies
  • Risk Factors
  • Staphylococcal Infections / etiology*
  • Vancomycin / therapeutic use
  • Vitreous Body / microbiology


  • Angiogenesis Inhibitors
  • Anti-Bacterial Agents
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Aptamers, Nucleotide
  • pegaptanib
  • Bevacizumab
  • Vancomycin
  • Ceftazidime
  • Ranibizumab