Incidence of Endophthalmitis after Intravitreal Injections: Risk Factors, Microbiology Profile, and Clinical Outcomes.

Abstract

PURPOSE:

To report the incidence and characteristics of endophthalmitis after intravitreal injections (IVI) of antivascular endothelial growth factor agents and triamcinolone acetonide.

METHODS:

Patients' medical records were retrospectively reviewed from January 2009 to June 2016, and the incidence, risk factors, clinical and microbiological characteristics of post-IVI endophthalmitis were evaluated.

RESULTS:

The total number of intravitreal injections given, which included ranibizumab, bevacizumab, and triamcinolone acetonide, was 20,566, of which 27 cases developed endophthalmitis, giving an overall incidence of 0.131%. Significant reduction (p < 0.003) in incidence of endophthalmitis was observed in patients who received prefilled compounded bevacizumab injections (0.050%) compared to multiple bevacizumab injections from a single vial (0.235%). In the triamcinolone acetonide group, the incidence was 0.26%. Staphylococcus species were isolated from 18 cases (67%), and all strains were sensitive to vancomycin.

CONCLUSIONS:

Adherence to strict aseptic protocols and use of prefilled compounded bevacizumab injections reduces the rate of post-IVI endophthalmitis.

• Authors: Chitaranjan Mishra, Prajna Lalitha, Gunasekaran Rameshkumar, Rupesh Agrawal, Praveen Kumar Balne, Mani Iswarya, Naresh Babu Kannan, Kim Ramasamy
• Journal: Ocular immunology and inflammation (Ocul Immunol Inflamm) Vol. 26 Issue 4 Pg. 559-568 ( 2018) ISSN: 1744-5078 [Electronic] England
• PMID: 29437495 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Bacteria (isolation & purification)
• Endophthalmitis (epidemiology, etiology, microbiology)
• Eye Infections, Bacterial (epidemiology, etiology, microbiology)
• Female
• Follow-Up Studies
• Humans
• Incidence
• India (epidemiology)
• Intravitreal Injections (adverse effects)
• Male
• Middle Aged
• Retinal Diseases (drug therapy)
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Ultrasonography
• Young Adult