September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Intravitreal Dexamethasone in the Management of Acute Endophthalmitis: A Comparative Study
Author Affiliations & Notes
  • Sam Abbassi
    Ophthalmology and Vision Sciences, UC Davis Medical Center, Sacramento, California, United States
  • Elad Moisseiev
    Ophthalmology and Vision Sciences, UC Davis Medical Center, Sacramento, California, United States
  • Susanna S Park
    Ophthalmology and Vision Sciences, UC Davis Medical Center, Sacramento, California, United States
  • Footnotes
    Commercial Relationships   Sam Abbassi, None; Elad Moisseiev, None; Susanna Park, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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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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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the effect of adding intravitreal dexamethasone on clinical outcome in the acute management of bacterial endophthalmitis

Methods : 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

Results : 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)

Conclusions : 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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