Endophthalmitis Postintravitreal Bevacizumab Injections: Incidence, Management, and Visual Outcome in Tertiary Care Center in Pakistan

PURPOSE: The purpose is to study the incidence, characteristics, management, and visual outcome of endophthalmitis postintravitreal bevacizumab (Avastin®) injections. METHODS: Retrospective cohort study conducted at Fauji Foundation Hospital that is a tertiary care center in Rawalpindi, Pakistan. The study duration was from January 1, 2015 to March 31, 2020. A total of 2321 eyes of 1407 patients were treated with Intravitreal bevacizumab (IVB) in a minor operation theater using standard aseptic measures. We studied the incidence, clinical characteristics, treatment, and visual outcomes of endophthalmitis post-IVB. RESULTS: Seven eyes (0.30%) out of 2321 eyes developed post-IVB endophthalmitis during the study period. Three eyes (42.8%) were culture positive and four eyes (57.2%) were culture negative. Five eyes (71.4%) showed visual improvement and two eyes (28.6%) did not show visual improvement. CONCLUSION: Prompt intravitreal antibiotic along with vitreous tap in cases of postintravitreal endophthalmitis may prevent vision loss which provides a useful alternative to immediate pars plana vitrectomy that requires more expertise, equipment, and an operation theater.