Lihteh Wu, MD (San Jose, Costa Rica), Maria A. Martinez- Castellanos, MD (Mexico City, Mexico), Hugo Quiroz-Mercado, MD (Mexico City, Mexico), J. Fernando Arevalo, MD, FACS (Caracas, Venezuela), Michel Eid Farah, MD, PhD (São Paulo, Brazil), Maria H. Berrocal, MD (Santurce, PR), Jose A. Roca, MD (Lima, Peru), Francisco J. Rodriguez, MD (Bogota, Colombia), Mauricio Maia, MD (São Paulo, Brazil), Teodoro Evans, MD (San Jose, Costa Rica), Pan American Collaborative Retina Study Group (PAC)


To report the systemic and ocular complications of an intravitreal injection of bevacizumab (Avastin®).


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. 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.


Nine hundred and ninety four intravitreal injections of bevacizumab in 782 eyes 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 retinal detachment or cataract were reported. The ocular complications included one case of uveitis and three cases  each of an increased intraocular pressure and endophthalmitis.


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.