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Martin Wilkes, Christopher D. Riemann, Michael R. Petersen, Daniel M. Miller, Robert E. Foster; A Comparison of Rates of Infectious Endophthalmitis after Intravitreal Injection. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1694.
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To determine whether there is a significant difference in the rate of infectious endophthalmitis following intravitreal injections with different therapies, at a high-volume, outpatient setting.
All patient encounters (42) with a coded diagnosis of endophthalmitis with preceeding intravitreal injection from the time period of 2006-2010 at Cincinnati Eye Institute were compiled. The diagnosis (true infectious endophthalmitis versus pseudo-endophthalmitis), agent administered (bevacizumab, ranibizumab, triamcinolone), indication for treatment, culture results, and final visual outcome were reviewed in detail.
There were a total of 11 cases of true, culture-confirmed infectious endophthalmitis. A total of 4 cases were associated with bevacizumab, 4 with ranibizumab, and 3 with triamcinolone.
Compounded bevicizumab has a much lower incidence of infectious endophthalmitis than ranibizumab. This may be attributable to the process in which ranibizumab is drawn up prior to injection. When taken into account the much higher volume of bevacizumab administered at our institution (3:1, bevicizumab vs ranibizumab), there is a relatively lower rate of endophthalmitis associated with this medication.
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