Endophthalmitis Associated With Intravitreal Injections of Anti-VEGF Agents at a Tertiary Referral Center: In-House and Referred Cases.

Abstract

BACKGROUND AND OBJECTIVE:

To report the incidence rates, causative organisms, and visual acuity (VA) outcomes in patients with endophthalmitis associated with intravitreal injection of anti-vascular endothelial growth factor inhibitors.

PATIENTS AND METHODS:

Retrospective case series between 2005 and 2017.

RESULTS:

The study included 39 eyes of 39 patients, including 27 (69%) referred and 12 (31%) institutional patients. The use of topical antibiotics after an injection was gradually phased out at the authors' institution, where the preinjection rate of all clinically suspected endophthalmitis was 0.013% (24 of 183,898). The most common isolates were coagulase-negative Staphylococcus and Streptococcus. A VA of 5/200 or better was achieved in 21 of 39 eyes (54%) overall and in two of 15 eyes (13%) infected with Streptococcus.

CONCLUSIONS:

The rate of post-intravitreal injection endophthalmitis is low. Outcomes were generally poor, and the worst were associated with Streptococcus. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:313-319.].

• Authors: Nicolas A Yannuzzi, Ninel Z Gregori, Philip J Rosenfeld, Nidhi Relhan, Nimesh A Patel, Nancy Si, Darlene Miller, Sander R Dubovy, William E Smiddy, Stephen G Schwartz, Harry W Flynn Jr
• Journal: Ophthalmic surgery, lasers & imaging retina (Ophthalmic Surg Lasers Imaging Retina) Vol. 49 Issue 5 Pg. 313-319 (05 01 2018) ISSN: 2325-8179 [Electronic] United States
• PMID: 29772041 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2018, SLACK Incorporated.

Chemical References

• Angiogenesis Inhibitors
• Vascular Endothelial Growth Factor A

Topics

• Adult
• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (administration & dosage)
• Endophthalmitis (epidemiology, microbiology)
• Eye Infections, Bacterial (epidemiology, microbiology)
• Female
• Gram-Negative Bacterial Infections (epidemiology, microbiology)
• Gram-Positive Bacterial Infections (epidemiology, microbiology)
• Humans
• Incidence
• Intravitreal Injections (adverse effects)
• Male
• Middle Aged
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity