Vitreous web after pars plana vitrectomy and bevacizumab with fluid-air exchange

Allen Chiang1, Shantan Reddy, Irena Tsui

  • 1Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, CA 90095, USA.

Seminars in Ophthalmology
|February 1, 2011
PubMed
Abstract

Insights

Intraocular inflammation after intravitreal bevacizumab can mimic infection. A unique web-like inflammatory response was observed post-operatively, resolving spontaneously without treatment.

Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Surgical Complications

Background:

  • Intravitreal bevacizumab is used for retinal conditions but can cause intraocular inflammation.
  • Inflammation can be infectious or non-infectious, requiring accurate diagnosis to avoid unnecessary treatment.

Observation:

  • A case report details a patient with diabetic retinopathy, macular edema, and epiretinal membrane.
  • The patient received intraoperative intravitreal bevacizumab during pars plana vitrectomy and related procedures.
  • Wide-field fundus photography documented a distinct web-like inflammatory response in the vitreous.

Findings:

  • Post-operative day one revealed vitreous opacities forming a web-like structure.
  • Minimal anterior chamber or vitreous cell was present, suggesting a sterile inflammatory process.
  • The inflammatory reaction completely resolved within one week.

Implications:

  • This case highlights a specific sterile inflammatory pattern following intravitreal bevacizumab.
  • Differentiating this sterile inflammation from infectious endophthalmitis is crucial for appropriate patient management.
  • Wide-field imaging aids in characterizing and monitoring such post-operative inflammatory responses.

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