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Sam Abbassi, Elad Moisseiev, Susanna S Park; Intravitreal Dexamethasone in the Management of Acute Endophthalmitis: A Comparative Study. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© 2017 Association for Research in Vision and Ophthalmology.
To determine the effect of adding intravitreal dexamethasone on clinical outcome in the acute management of bacterial endophthalmitis
Retrospective chart review of 63 eyes of 63 patients with acute bacterial endophthalmitis and treated with vitreous tap and intravitreal injection of antibiotics, 19 eyes (30.2%) with concurrent intravitreal dexamethasone (Dex group) and 44 eyes (69.8%) without intravitreal dexamethasone (No Dex group). Demographic, ocular history, visual acuity (VA) at presentation and during follow up, and the occurrence of any ocular complications or need for additional ocular interventions during follow-up were recorded
Among 63 eyes studied, 40 had postoperative endophthalmitis, 7 were caused by intravitreal injections, 4 were traumatic, and 12 had endogenous endophthalmitis. VA had significantly improved from 2.10±0.69 logMAR at presentation to 1.89±0.86 logMAR by one week (p=0.008), and 1.54±0.94 logMAR by one month (p<0.001). Improvement was maintained long term with a mean final VA of 1.43±1.02 logMAR (p<0.001). There were no differences in visual outcome or rates of ocular complications between Dex and No Dex groups. None of the eyes in the Dex group required repeat intravitreal antibiotic injection, while 6 eyes (13.6 %) in the No Dex group required repeat intravitreal antibiotic treatment during the first week following initial treatment (p=0.09)
In this retrospective review of acute endophthalmitis cases of varied etiology treated with vitreous tap and intravitreal antibiotics, mean visual acuity was significantly improved following treatment with vitreous tap and intravitreal antibiotics. Although the addition of intravitreal dexamethasone in the acute management was not associated with a significant difference in clinical outcome, a trend toward less need for repeat intravitreal antibiotic therapy was noted in eyes treated with concurrent intravitreal dexamethasone, perhaps from improved control of associated inflammation
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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