June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Endophthalmitis Associated with Intravitreal Injection of Anti-VEGF Agents at a Tertiary Referral Center from 2018-2019
Author Affiliations & Notes
  • Daniela Reyes-Capo
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Nicolas Yannuzzi
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Ninel Z Gregori
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Philip J Rosenfeld
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Nidhi Relhan
    Ophthalmology, Tulane University School of Medicine, New Orleans, Louisiana, United States
  • Nimesh Patel
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Nancy Si
    Family Medicine, North Florida Regional Medical Center, Gainesville, Florida, United States
  • Darlene Miller
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Sander R Dubovy
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • William E Smiddy
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Stephen G Schwartz
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Harry W Flynn
    Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Daniela Reyes-Capo, None; Nicolas Yannuzzi, None; Ninel Gregori, None; Philip Rosenfeld, None; Nidhi Relhan, None; Nimesh Patel, None; Nancy Si, None; Darlene Miller, None; Sander Dubovy, None; William Smiddy, None; Stephen Schwartz, None; Harry Flynn, Supported by the National Institutes of Health, Bethesda, Maryland (Center Core grant no.: P30EY014801); Research to Prevent Blindness, Inc, New York, New York. (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4406. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Daniela Reyes-Capo, Nicolas Yannuzzi, Ninel Z Gregori, Philip J Rosenfeld, Nidhi Relhan, Nimesh Patel, Nancy Si, Darlene Miller, Sander R Dubovy, William E Smiddy, Stephen G Schwartz, Harry W Flynn; Endophthalmitis Associated with Intravitreal Injection of Anti-VEGF Agents at a Tertiary Referral Center from 2018-2019. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4406.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : To report the incidence and clinical features of infectious endophthalmitis after intravitreal (IV) injection of vascular endothelial growth factor inhibitors (anti-VEGF) from 2018-2019 and to compare these findings to the characteristics of endophthalmitis after anti-VEGF injection from 2005-2017.

Methods : Retrospective case series of clinical and microbiology records of patients treated at a tertiary referral center between 01/01/2018-10/31/2019 for clinically diagnosed endophthalmitis occurring ≤ 4 weeks after IV anti-VEGF injection.

Results : Following injections at our institution, the rate of clinically diagnosed endophthalmitis was 0.011% (5/44,196) and of culture positive endophthalmitis was 0.007% (3/44,196). The overall endophthalmitis rates per injection were as follows: aflibercept (clinically diagnosed 0.020% [5/24,965], culture positive 0.012% [3/24,965]); bevacizumab 0% (0/16,255); and ranibizumab 0% (0/2,976). The overall rates of endophthalmitis among all injections from 2018-2019 are similar to previously published data of endophthalmitis after IV anti-VEGF from 2005-2017 (clinically diagnosed 0.011% vs 0.013% [p=0.74], culture positive 0.007% vs 0.007%, [p=1.00]). However, the incidence of endophthalmitis after aflibercept from 2018-2019 was slightly increased from 2005-2017, though this difference was not significant (clinically diagnosed 0.020% vs 0.014% [p=0.53], culture positive 0.012% vs 0.004% [p=0.19]).

From 2018-2019, 7 eyes had culture positive endophthalmitis, 3 (43%) from injections performed at our institution and 4 from referred practices. All in house positive cultures resulted from aflibercept. Of the referred cases, 3/4 occurred after bevacizumab and 1/4 after aflibercept. All cases of endophthalmitis occurred ≤ 5 days after IV injection. The causative organisms were coagulase negative Staphylococcus (5/7) and Streptococcus (2/7). Only one eye achieved a VA better than 20/200 and the two eyes infected with Streptococcus required enucleation.

Conclusions : Endophthalmitis rates after IV anti-VEGF remain low and poor outcomes were associated with Streptococcus. These findings are similar to prior data from 2005-2017. However, in contrast to the 2005-2017 series in which ranibizumab was responsible for the majority of cases, aflibercept had the highest rate of endophthalmitis in 2018-2019 possibly due to the increased use of aflibercept.

This is a 2020 ARVO Annual Meeting abstract.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×