June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
The influence of universal face mask use on endophthalmitis risk after intravitreal anti-vascular endothelial growth factor injections during the COVID-19 pandemic
Author Affiliations & Notes
  • Samir N Patel
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Peter Tang
    VitreoRetinal Surgery, Minnesota, United States
  • Philip P Storey
    Austin Retina Associates, Austin, Texas, United States
  • Jeremy Wolfe
    Associated Retinal Consultants, Michigan, United States
  • Jordana Fein
    Retina Group of Washington, District of Columbia, United States
  • Priya Vakharia
    Retina Group of Washington, District of Columbia, United States
  • Sumit P Shah
    NJ Retina, New Jersey, United States
  • Jonathan Prenner
    NJ Retina, New Jersey, United States
  • Eric Chen
    Retina Consultants of Texas, Houston, Texas, United States
  • Patrick Williams
    Texas Retina Associates, Texas, United States
  • Chirag Shah
    OCB, Boston, Massachusetts, United States
  • Philip ferrone
    Vitreoretinal Consultants of New York, New York, United States
  • Michelle Liang
    Tufts Medical Center, Boston, Massachusetts, United States
  • Maxwell Stem
    Pennsylvania Retina Specialists, Pennsylvania, United States
  • Yoshihiro Yonekawa
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Sunir J. Garg
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Samir Patel, None; Peter Tang, None; Philip Storey, None; Jeremy Wolfe, None; Jordana Fein, None; Priya Vakharia, None; Sumit Shah, None; Jonathan Prenner, None; Eric Chen, None; Patrick Williams, None; Chirag Shah, None; Philip ferrone, None; Michelle Liang, None; Maxwell Stem, None; Yoshihiro Yonekawa, None; Sunir Garg, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1354. doi:
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      Samir N Patel, Peter Tang, Philip P Storey, Jeremy Wolfe, Jordana Fein, Priya Vakharia, Sumit P Shah, Jonathan Prenner, Eric Chen, Patrick Williams, Chirag Shah, Philip ferrone, Michelle Liang, Maxwell Stem, Yoshihiro Yonekawa, Sunir J. Garg; The influence of universal face mask use on endophthalmitis risk after intravitreal anti-vascular endothelial growth factor injections during the COVID-19 pandemic. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1354.

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

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Abstract

Purpose : Routine use of face masks for both patients and physicians during intravitreal anti-vascular endothelial growth factor (VEGF) injections has increased with the emergence of the COVID-19 pandemic. This study evaluates the impact of physician, ancillary staff, and patient face mask use on rates and outcomes of post-injection endophthalmitis.

Methods : In this retrospective comparative cohort study, all eye receiving intravitreal anti-VEGF factor injections from 10/1/2019 to 7/31/2020 were included from twelve centers. Cases were divided into a “no face mask” group if no face masks were worn by the physician or patient during intravitreal injections or a “universal face mask” group if face masks were worn by the physician, ancillary staff, and patient during intravitreal injections. The main outcome measures were rate of endophthalmitis, visual acuity, and microbial spectrum.

Results : Of 505,968 intravitreal injections administered, 85 of 294,514 (0.0289%; 1 in 3,464 injections) cases of endophthalmitis occurred in the “no face mask” group, and 45 of 211,454 (0.0213%; 1 in 4,699 injections) cases occurred in the “universal face mask” group (odds ratio, 0.74; 95%CI, 0.51–1.18; p=0.097; Table 1). In the “no face mask” group, there were 27 cases (0.0092%; 1 in 10,908 injections) of culture-positive endophthalmitis compared to 9 cases (0.004%; 1 in 23,494 injections) in the “universal face mask” group (OR, 0.46; 95%CI, 0.22–0.99; p=0.041). Three cases of oral flora-associated endophthalmitis occurred in the “no face mask” group (0.001%; 1 in 98,171 injections) compared to one (0.0005%; 1 in 211,454) in the “universal face mask” group (p=0.645). At endophthalmitis presentation, mean logMAR visual acuity was 2.04 for “no face mask” group compared to 1.65 for the “universal face mask” group (p=0.022), although no difference was observed three months after treatment (p=0.764; Table 2).

Conclusions : Universal face mask use during intravitreal anti-VEGF injections did not show a statistically significant reduction in presumed endophthalmitis, but there was a reduced rate of culture-positive endophthalmitis. Future studies are warranted to assess the role of face mask use to reduce endophthalmitis risk, particularly that due to oral flora.

This is a 2021 ARVO Annual Meeting abstract.

 

Rates of endophthalmitis

Rates of endophthalmitis

 

Visual acuity outcomes

Visual acuity outcomes

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