Vascular events in patients with age-related macular degeneration treated with intraocular bevacizumab

The purpose of this study was to determine the incidence of vascular events in patients treated with intraocular injections of bevacizumab.

The subjects were 769 persons (mean age, 79.9 years; range, 47-97 years) from the Barnes Retina Institute in St. Louis. Patients received at least one intraocular injection of bevacizumab for the treatment of neovascular age-related macular degeneration. The study endpoints included myocardial infarction, cerebrovascular accident, thromboembolic disease, new hypertension, bleeding, and death.

There were events in 74 patients (9.6%; 95% confidence interval, 7.5-11.7%) over a mean follow-up of 13.2 months (range, 1-23 months). Among other events, 15 patients (2.0%; 95% confidence interval, 1-3%) had a nonlethal myocardial infarction, 27 patients (3.5%; 95% confidence interval, 2.2-4.8%) had an episode of new or increased blood pressure, and 19 patients (2.5%; 95% confidence interval, 1.4-3.6%) died. There was no correlation between the number of bevacizumab injections and incidence of any event.

Intraocular bevacizumab may be safe for intraocular use from a systemic standpoint.