Herpetic epithelial keratitis after intravitreal injection of bevacizumab (avastin).

PURPOSE: To report a case of herpetic epithelial keratitis that developed after intravitreal bevacizumab (Avastin) injection.

METHODS: A 63-year-old man with diabetes with proliferative diabetic retinopathy and macular edema received intravitreal injection of bevacizumab (Avastin) in his right eye.

RESULTS: Three days after the injection, the patient presented with foreign body sensation, redness, tearing, photophobia, and decreased visual acuity in the right eye. The cornea showed an arborizing dendritic epithelial lesion with terminal bulb typical of herpes simplex virus (HSV) epithelial keratitis. HSV-DNA was detected in corneal scrapings using polymerase chain reaction. A diagnosis for herpes simplex epithelial keratitis was made. Topical acyclovir ointment therapy was initiated with good resolution of HSV signs and symptoms.

CONCLUSIONS: Herpes simplex epithelial keratitis can be a possible complication of intravitreal bevacizumab (Avastin) injection. To our knowledge, this case is the first report of herpetic epithelial keratitis after intravitreal bevacizumab (Avastin) injection.