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Nadim Rayess, Ehsan Rahimy, Michael Dollin, Philip Storey, Sunir Garg, Chirag Shah, Jeremy Wolfe, Jason Hsu; Endophthalmitis rates and clinical features following intravitreal anti-vascular endothelial growth factor injections for diabetic eye disease versus neovascular age-related macular degeneration and retinal vein occlusion. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3857.
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To determine whether patients receiving intravitreal anti-vascular endothelial growth factor (VEGF) injections for diabetic eye disease have a greater incidence of endophthalmitis compared to patients receiving injections for neovascular age-related macular degeneration (AMD) or retinal vein occlusion (RVO).
This is a retrospective, multicenter, observational, case series of patients who received intravitreal anti-VEGF injections (bevacizumab, ranibizumab, or aflibercept) for the diagnosis of neovascular AMD, branch RVO, central RVO, diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR) between January 1, 2009 and September 30, 2013 at Mid Atlantic Retina and the Retina Service of Wills Eye Hospital (Philadelphia, PA), Ophthalmic Consultants of Boston (Boston, MA), or Associated Retinal Consultants at William Beaumont Hospital (Royal Oak, MI). Patient records were reviewed for age, gender, affected eye, indication for receiving intravitreal injections, visual acuity, diagnoses, isolated organisms and sensitivities, number of injections received, procedures performed, and complete ophthalmic examination of both eyes.
A total of 133 cases of endophthalmitis following 308,113 intravitreal anti-VEGF injections (1/2317) were identified. 111 cases of endophthalmitis occurred out of 257,985 injections for neovascular AMD (1/2324), 14 cases occurred out of 22,512 injections for DME/PDR (1/1608), and 8 cases occurred out of 27,616 injections (1/3451) for BRVO/CRVO. Chi-square analysis (Stata 12, College Station, Tx) comparing patients with DME/PDR to patients with AMD found no difference in rates of endophthalmitis (p=0.19). Patients with DME/PDR had similar rates to those with RVO (p=0.08), as did patients with AMD compared to those with RVO (p=0.28).
Endophthalmitis following intravitreal injections is a rare complication. There are no differences in endophthalmitis rates between patients with AMD, DME/PDR, and RVO after anti-VEGF injection.
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