Abstract
Purpose :
We report three cases in which patients receiving chronic intravitreal anti-VEGF therapy for exudative age-related macular degeneration (ARMD) exhibited inactivation of CNV following development of endophthalmitis, negating the need for anti-VEGF therapy following endophthalmitis resolution.
Methods :
We retrospectively reviewed the medical records of endophthalmitis patients with a history of exudative ARMD and identified three female patients with mean age 87 (range: 79-93) receiving anti-VEGF therapy for exudative ARMD who developed postinjection endophthalmitis. Examination for post endophthalmitis exudative maculopathy was performed by clinical examination and OCT.
Results :
Following resolution of the endophthalmitis, there was notable inactivation of their exudative maculopathy in all patients as observed on OCT. Prior to endophthalmitis, all patients received anti-VEGF therapy (bevacizumab n=2 both every 5 -6 weeks; ranibizumab n=1 every 8 weeks). All three patients received intravitreal vancomycin and ceftazidime. Two patients were additionally treated with pars plana vitrectomy surgery.
In all three cases, inactivation of the exudative maculopathy following endophthalmitis resolution was observed and no subsequent anti-VEGF injections were needed in the eye affected by endophthalmitis (mean follow-up time following endophthalmitis diagnosis: 218.7 days, range 148-263). All three patients also had exudative ARMD in their contralateral eye, with one of three patients no longer requiring anti-VEGF injections in their contralateral eye.
Conclusions :
Development of anti-VEGF post-injection endophthalmitis was associated with inactivation of the exudative maculopathy in patients with exudative ARMD. Further study is warranted to elucidate the etiology of presumed CNV inactivation after resolution of endophthalmitis.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.