Safety of an Intravitreal Injection of Bevacizumab
(Avastin®): Results of a Multicenter Trial
Michel Eid Farah (Sao Paulo)
Purpose: To report the systemic and ocular complications of an intravitreal injection of
bevacizumab (Avastin®).
Methods: Open label, uncontrolled clinical study of eyes injected with either 1.25 mg or 2.5
mg intravitreal bevacizumab for a variety of retinal disorders including diabetic macular
edema, macular edema secondary to branch and central retinal vein occlusions, proliferative
diabetic retinopathy, neovascular glaucoma and choroidal neovascularization secondary to
age-related macular degeneration, myopia and idiopathic causes. Patients underwent a
complete ocular examination at baseline, weekly during the first month and then every month. Monitored systemic conditions included myocardial infarction, stroke, systemic hypertension,
thromboembolic diseases and death.
Bevacizumab was stored under refrigeration in two different ways: 1- A single vial of 100 mg /4 mL was re-utilized as needed;
and 2- The contents of the vial was aliquoted out into single use injections under sterile conditions.
Results: 994 intravitreal injections of bevacizumab in 714 patients were reported from eight centers in seven countries. No
cases of death, myocardial infarction, stroke, thromboembolic diseases, or colonic perforation were reported. No cases of
endophthalmitis, uveitis, retinal detachment, elevation of intraocular pressure or cataract were reported.
Conclusion: An intravitreal injection of either 1.25 mg or 2.5 mg of bevacizumab appears to be safe and well tolerated
during the first three months. Monitoring of the adverse side effects in these patients will continue.