Marginal Keratitis After Intravitreal Injection Of Bevacizumab (Avastin)
Published 2024 - 42nd Congress of the ESCRS
Reference: PO865 | Type: Poster | DOI: 10.82333/56xd-e367
Authors: Clara Lara Aroco* 1 , María Ángeles Ibáñez Ruiz 1 , Silvia Beatriz De Miguel Martín 1 , Rosa María Jiménez Escribano 1 , Cristina García-Velarde Angulo 1
1Complejo Hospitalario Universitario de Toledo,Toledo,Spain
Purpose
To report a case of marginal keratitis that developed after intravitreal bevacizumab (Avastin) injection.
Setting
A 88-year-old woman with Age-related macular degeneration (AMD) and macular edema in both eyes received four intravitreal injections of bevacizumab (Avastin) in left eye and five in right eye. No previous history of herpes.
Methods
Case report
Results
Two days following the fifth injection of Avastin in the patient's right eye, she experienced sensations akin to having a foreign body, accompanied by redness and a decrease in visual acuity in that eye. Examination with a slit lamp revealed peripheral infiltrates beneath the corneal epithelium, delineated from the limbus by a clear zone. Additionally, there was corneal edema with folds in the endothelium and a mild anterior chamber reaction. No presence of hypopyon was noted. The patient's symptoms showed favorable response to topical steroid and topic and oral antibiotic medications.
Conclusions
The intravitreal use of bevacizumab poses a risk of inducing hypersensitivity reactions, such as marginal keratitis. As trials on anti-VEGF agents expand, further investigation into their potential adverse effects is crucial. Current literature reports cases of herpetic keratitis post-bevacizumab injection. Additionally, we noted a case of marginal keratitis after a COVID-19 vaccine and another post-ranibizumab injection. This case appears to be the first report of marginal epithelial keratitis following intravitreal bevacizumab injection.