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A Large Outbreak of Fulminant Bacterial Endophthalmitis after Intravitreal Injection of Counterfeit Bevacizumab

  • Inflammatory Disorders
  • Published:
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Abstract

Purpose

This study reports the findings in a large series of patients with acute bacterial endophthalmitis after intravitreal injection of bevacizumab (IVB) in two eye hospitals.

Methods

Medical records were reviewed for patients who presented with acute fulminant endophthalmitis in one or two eyes following intravitreal injection of bevacizumab from two separate batches in two eye hospitals.

Results

Twenty-eight eyes of 21 patients presented with acute endophthalmitis 12–48 hours after IVB injection. Cultures from the eyes and the vials were positive for E. coli and Citrobacter, each in one of the hospitals. All patients were initially treated with topical, intravitreal, and systemic antibiotics. Twenty-four eyes underwent pars plana vitrectomy. Best corrected visual acuity (BCVA) was 1.27 ± 0.89 logMAR before IVB injecti,on which decreased to 2.80 ± 0.45 LogMAR after presentation of endophthalmitis and 2.12 ± 0.97 logMAR three months after IVB injection. Final visual acuity was found to be no light perception in four eyes.

Conclusions

This large outbreak of E.coli and Citrobacter endophthalmitis occurred after intravitreal injection of counterfeit bevacizumab. Visual outcomes were very poor.

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Author information

Authors and Affiliations

  1. Ophthalmic Research Center, Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti Medical Sciences, Shahid Madani Ave., Tehran, Iran

    Morteza Entezari

  2. Ophthalmic Research Center, Department of Ophthalmology, Torfe Hospital, Shahid Beheshti Medical Sciences, Tehran, Iran

    Saeed Karimi

  3. Ophthalmic Research Center, Department of Ophthalmology, Labbafinejad Hospital, Shahid Beheshti Medical Sciences, Tehran, Iran

    Hamid Ahmadieh

  4. Ophthalmic Research Center, Department of Ophthalmology, Razi Hospital, Tehran, Iran

    Amir Hossein Mahmoudi & Hamid Parhizgar

  5. Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran

    Mehdi Yaseri

Authors
  1. Morteza Entezari
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  2. Saeed Karimi
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  3. Hamid Ahmadieh
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  4. Amir Hossein Mahmoudi
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  5. Hamid Parhizgar
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  6. Mehdi Yaseri
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Corresponding author

Correspondence to Morteza Entezari.

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No funding was received for this research.

Conflict of Interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. For this type of study, formal consent is not required.

Additional information

The work was carried out by Ophthalmic Research center Shahid Beheshti Medical University.

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Entezari, M., Karimi, S., Ahmadieh, H. et al. A Large Outbreak of Fulminant Bacterial Endophthalmitis after Intravitreal Injection of Counterfeit Bevacizumab. Graefes Arch Clin Exp Ophthalmol 254, 1851–1856 (2016). https://doi.org/10.1007/s00417-016-3426-7

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  • DOI: https://doi.org/10.1007/s00417-016-3426-7

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