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Hiroki Otsuka, Noboru Arimura, Taro Kamisasanuki, Yukiko Matsuo, Futoshi Otsuji, Yasushi Sonoda, Keita Yamakiri, Taiji Sakamoto; Non-infectious Endophthalmitis After Intravitreal Injection of Triamcinolone Acetonide. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5597.
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© ARVO (1962-2015); The Authors (2016-present)
Intravitreal injection of triamcinolone acetonide (IVTA) has been commonly used worldwide in the treatment of macular edema from various causes. Non-infectious endophthalmitis has been reported after IVTA. We report the clinical experience of remarkable increase in the rate of non-infectious endophthalmitis and clinical findings during 2 years from 2008 to 2009.
Clinical records were reviewed for all patients who received IVTA between 1 January 2008 and 31 December 2009 at the Kagoshima University.
Between 1 January 2008 and 31 December 2008, 65 eyes underwent IVTA. Two eyes (3.1%) developed non-infectious endophthalmitis. From 1 January 2009 to 31 December 2009, 29 eyes underwent IVTA. Six eyes (20.7%) developed non-infectious endophthalmitis. Eight eyes with non-infectious endophthalmitis involved diabetic macular edema (n=4), retinal vein occulusion (n=2) and age related macular degeneration (n=2). The common clinical findings were painless blurring of vision (n=6), iritis (n=8), hypopyon (n=3) and vitritis (n=7), and all the eyes presented next day after the injection. Three eyes with high inflammatory reaction received pars plana vitrectomy (PPV). Five eyes were treated with topical medications. Five eyes regained vision equally or better than pre-injection level. In the cases which underwent PPV or anterior chamber tap, there were all found to be negative for bacterial culture.
A remarkable increase in the rate of non-infectious endophthalmitis was found during a year in 2009, when compared with the same period in 2008. The cause of this increased incidence is still unclear. Visual outcomes in all the eyes were generally good.
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