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Mahdi Rostamizadeh, musa abdelaziz, Achal Patel, Majid Moarefi, David Miller, Lawrence J Singerman, Joseph Coney, Michael Novak, Llewelyn Rao, Scott Pendergast; Incindences of Endophthalmitis in Various Anti-VEGF Treatments. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5025.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Anti-vegf therapy has become the mainstay treatment of many retinal diseases. Though the risk of complications is relatively low, endophthalmitis remains the most devastating complication. The purpose of our study is to determine which anti vegf therapy – ranibizumab, bevacazimub, or afiblercept – had the most post injection endophthalmitis outcomes. We hypothesize that bevacazimub will have the highest rate, as it needs to be processed at a compounding pharmacy which has a higher potential of contamination.
Methods: After approval was obtained from Retina Associates of Cleveland institutional review board, electronic medical charts were searched based on international classification of disease codes 9 and 10 for intravitreal injections and endophthalmitis. A total of 110,246 injections were given over a 5 year period: 54,814 bevacizumab, 33,844 ranibizumab and 21,588 aflibervept. After accounting for duplicates, excluding cataract and bleb related endophthalmitis we identified 32 patients that had endophthalmitis after an injection. We divided the number of endophthalmitis cases by the total amount of injections in each group to find the incidence.
Results: Out of all the patients given injections, 0.029% developed endophthalmitis. Bevacizumab was found to have the lowest at 0.016%. Ranibizumab had the second lowest at 0.029%. Aflibercept had the highest incidence of post injection endophthalmitis at 0.046%.
Conclusion: Our results show that aflibercept had the highest risk of post infectious endophthalmitis. Contrary to what we initially believed, bevacizumab had the least incidence of post infectious endophthalmitis. Research regarding patient preparation prior to therapy administration may reveal further differences between therapy results.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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