Intravitreal Injection of Bevacizumab: Review of our previous Experience

Several ocular and systemic complications have been reported after the bevacizumab intravitreal injection. This study aims at reporting the main indications for the bevacizumab intravitreal injection in our center, the intravitreal injection method in this study, and the incidence of the post-injection complication, such as endophthalmitis. This study is a retrospective review of the consecutive intravitreal bevacizumab (Avastin (R)) injections for 359 patients between 2011 and 2013 at a single institute (Poostchi Clinic of Ophthalmology). Before the injection, a drop containing 5 mL Ciprofloxacin and 5 mL Betadine 10% was applied 3 times at the intervals of 10 min. The eye lashes, upper and lower eyelids, and caruncle were swabbed with Betadine 10% but the lid speculum, drape, and conjunctival washing were not conducted. The patients were followed up 8 weeks after the injection for the evaluation of any complications. In this study, 1376 intravitreal injection of bevacizumab in 479 eyes of 359 patients were enrolled. Among them, 141 patients (39.3%) were men and 218 (60.7%) were women. The mean age (+/- SD) of the patients was 61.48 (+/- 11.21) years. On average, each patient received 3.83 (the range 1-13) injections. The most common indications for the bevacizumab intravitreal injection were diabetic retinopathy, choroidal neovascularization, and central retinal vein occlusion. None of the patients developed endophthalmitis, retinal detachment, or other adverse effects. This study showed that the above-mentioned method of the intravitreal bevacizumab injection is easy and safe. The future studies involving more participants are required for the evaluation of rare complications.