Jundishapur Journal of Medical Sciences

Jundishapur Journal of Medical Sciences

Risk Factors and Prevalence of Endophthalmitis after Intravitreal Injection of Anti-VEGF Drugs: A Systematic Review and Meta-Analysis

Document Type : Review

Authors
Maryam Adabi 1
Rozhin Kasiri 2
Fatemeh Shahbazi 3
Zahra Shokati Eshkiki 4
1 Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2 Infectious Ophthalmologic Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
3 Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
4 Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
10.22118/jsmj.2026.568368.4123
Abstract
To determine the worldwide incidence of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) medications, we carried out a systematic review and meta-analysis. To locate relevant research published up to June 2024, searches were conducted via PubMed, Scopus, Web of Science, and Google Scholar. Among the search phrases used were "endophthalmitis," "intravitreal injection," "anti-VEGF," "bevacizumab," "Avastin," "aflibercept," and "ranibizumab." The incidence of endophthalmitis in individuals who received intravitreal injection of anti-VEGF alone was only recorded in these trials. 136 of the 1563 identified references could be included in the meta-analysis after duplicates and irrelevant papers were eliminated. After evaluating 23,809,816 intravitreal anti-VEGF injections, the estimated incidence of endophthalmitis was 0.0382 (95% CI: 0.034 to 0.042). The study's findings indicate that endophthalmitis is uncommon after intravitreal injections of anti-VEGF drugs; yet, paying close attention to infection prevention and management guidelines is still crucial due to the potentially serious repercussions of this condition.
Keywords
Endophthalmitis
Intravitreal injection
anti-VEGF
Subjects
 
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Authors retain the copyright and full publishing rights.
Published by Ahvaz Jundishapur University of Medical Science. This article is an open access article licensed under the Creative Commons Attribution-NonCommercial 4.0 (https://creativecommons.org/licenses/by-nc/4.0/).
 
 
 
 
 
 
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  • Receive Date 24 December 2025
  • Revise Date 28 January 2026
  • Accept Date 28 January 2026