Risk of endophthalmitis following anti-VEGF injection is low

The incidence of suspected endophthalmitis in patients who have received intravitreal anti-vascular endothelial growth factor (VEGF) treatments in a community setting is very low, according to a study published in the May 2008 issue of the American Journal of Ophthalmology.

Suman Pilli of the Vitreous Retina Macula Consultants of New York and the LuEsther T. Mertz Retinal Research Center at Manhattan Eye, Ear, and Throat Hospital, New York, US and colleagues conducted a retrospective interventional case series of 10254 intravitreal anti-VEGF injections (ranibizumab, n=6347; bevacizumab, n=3501; pegaptanib, n=406) performed in an office setting without preinjection antibiotics between January 5 2005 and October 18 2007.

There were no cases of confirmed endophthalmitis and three cases of suspected endophthalmitis (ranibizumab, n=2; bevacizumab, n=1; pegaptanib, n=0), after which all three patients regained pre-injection visual acuity.

The rate of suspected endophthalmitis was 0.029%, which is comparable to the rate reported when more rigorous preventative measures are taken, such as in a clinical trials setting.