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Incidence of Endophthalmitis after Intravitreal Injections: Risk Factors,Microbiology Profile,and Clinical Outcomes |
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| Authors: | Chitaranjan Mishra Gunasekaran Rameshkumar Rupesh Agrawal Praveen Kumar Balne Mani Iswarya |
| Affiliation: | 1. Department of Vitreo-retina Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India;2. Department of Ocular Microbiology, Aravind Eye Hospital, Madurai, Tamil Nadu, India;3. National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore;4. Translational Pre-Clinical Model Platform, Singapore Eye Research Institute, Singapore;5. Department of Biostatistics, Aravind Eye Hospital, Madurai, Tamil Nadu, India |
| 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. |
| Keywords: | Bacterial infection bevacizumab endophthalmitis intravitreal injection ranibizumab triamcinolone acetonide |