Incidence of Endophthalmitis Related to Intravitreal Injection of Bevacizumab and Ranibizumab

In Brief Purpose: To report the overall incidence of endophthalmitis associated with office based intravitreal injections of bevacizumab and ranibizumab. Methods: This is a retrospective, consecutive, multicenter case series involving four large clinical sites. Included were all patients receiving at least one injection of intravitreal bevacizumab or intravitreal ranibizumab. Follow-up after each injection was at least 4 weeks. Results: A total of 12,585 injections of intravitreal bevacizumab and 14,320 injections of intravitreal ranibizumab were given during the study period. Infectious endophthalmitis developed in three patients after administration of bevacizumab and in three patients after administration of ranibizumab. Four of these patients were culture positive. Rates of endophthalmitis were 0.02% and 0.02%, respectively, with an overall rate of 0.02%. Conclusion: The rate of endophthalmitis associated with intravitreal bevacizumab and ranibizumab is low, with an incidence of approximately 1 in 4,500 injections. With the advent of anti-VEGF treatments, the risk of endophthalmitis becomes one of great importance. The goal of this multi-center study was to report the per injection incidence of endophthalmitis for intravitreal bevacizumab and ranibizumab. The approximate rate of endophthalmitis was found to be 1 in 4,500 injections.