Jundishapur Scientific Medical Journal

Jundishapur Scientific Medical Journal

Risk factors and prevalence of endophthalmitis after intravitreal injection of anti-VEGF drugs: a systematic review and meta-analysis.

Document Type : Review

Authors
Zahra Shokati Eshkiki 1
Rozhin Kasiri 2
Fatemeh Shahbazi 3
Maryam Adabi 4
1 Alimentary Research Center,, Clinical Sciences Research Institute,, Ahvaz Jundishapur University of Medical Sciences,
2 Jundishapur university of medical sciences
3 Hamadan University of medical sciences,
4 Shahid Sadoughi University of Medical Sciences
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

  • Receive Date 24 December 2025
  • Revise Date 28 January 2026
  • Accept Date 28 January 2026