Acute endophthalmitis following intravitreal bevacizumab (Avastin) injection

Purpose: To report two cases of acute endophthalmitis following intravitreal bevacizumab injection. Methods: Two patients with exudative age-related macular degeneration were treated sequentially with an intravitreal injection of bevacizumab and developed signs of severe but painless infectious endophthalmitis 2 days later. Vitreous samples were obtained, followed by the injection of vancomycin 1 mg/0.1 ml and ceftazidime 2.25 mg/0.1 ml. Pulsed-field gel electrophoresis (PFGE) was used to determine whether the isolated microorganisms were the same. Results: Coagulase-negative staphylococci were identified and isolated from the vitreous specimen of both patients. PFGE revealed different patterns of banding, excluding that interpatient contamination occured. Conclusions: Infectious endophthalmitis is a potential complication of intravitreal bevacizumab injection.