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Andrew A. Chang, Matthew Simunovic, Ryan Rush; Endophthalmitis Following Intravitreal Injection Versus Endophthalmitis Following Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1692.
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To describe and compare the causative organisms, clinical features and visual outcomes of endophthalmitis following intravitreal injection (IVI) to endophthalmitis following cataract surgery (CS).
Retrospective case series.Patient Population & Setting: Patients with acute endophthalmitis following either CS or IVI presenting to a tertiary referral centre - Sydney Eye Hospital - between 2007 and 2010. Main outcome measures: 1. identification of the causative organism; 2. time to presentation; 3. odds of improvement in visual acuity following treatment; 4. odds of final visual acuity of counting fingers or less and 5. odds of enucleation.
Of the 101 patients in this study, 48 had preceding CS and 53 had preceding IVI. There was an increased incidence of Streptococcus spp. endophthalmitis in post IVI cases (24.53% versus 6.25%; odds ratio (OR) 5.85; P = 0.022). Endophthalmitis following IVI had increased likelihood of a final visual acuity of counting fingers or less (OR = 6.0; P < 0.01), decreased likelihood of any improvement in acuity following treatment (OR = 0.13; P <0.01) and an increased likelihood of presenting within a week of the procedure (OR = 3.93; P <0.01). Streptococcus spp. endophthalmitis was associated with increased likelihood of a final visual acuity of counting fingers or less (OR = 10.2; P < 0.01), decreased likelihood of any improvement in acuity following treatment (odds ratio = 0.06; P < 0.01) and increased likelihood of enucleation (OR = 17.11; P < 0.01).
Post IVI endophthalmitis is associated with an increased incidence of Streptococcus spp. infection, earlier presentation and poorer visual outcomes when compared to post CS endophthalmitis.
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