Abstract
Purpose :
To analyze the incidence rates of endophthalmitis after intravitreal injection of the following medications: bevacizumab (BEVA), brolucizumab (BROL), aflibercept (AFL), ranibizumab (RAN), dexamethasone implant (DEXA), and triamcinolone acetonide (TRIA).
Methods :
A retrospective cohort study was performed at a private retinal practice in Ohio. The Institutional Review Board (Sterling) determined this study consisted of non-human subjects. All data was collected through the practice management of Retina Associates of Cleveland, Inc. Data was collected from patients who received injections over a 2 year period of AFL, BEVA, BROL, DEXA, TRIA and RAN from January 2020 through November 2021 and includes: patient number, injection service dates, intravitreal drug injected, procedure codes, and primary diagnoses. The rates of endophthalmitis were then compared amongst the different injections. The total percentage of endophthalmitis cases was tabulated as well.
Results :
From January 2020 through November 2021, 109,202 injections were administered. The breakdown of the 109,202 injections was as follows: 66,095 AFL, 28,762 BEVA, 8,650 RAN, 3,010 BRON, 1,958 DEXA and 727 TRIA. Of the 109,202 injections, 39 (0.036%) cases of endophthalmitis occurred. Of the 39 endophthalmitis cases, 22 (0.033% of total AFL injections) after AFL injection, 5 (0.688% of total TRIA injections) after TRIA injection, 5 (0.03% of total BEVA injections) after BEVA injection, 3 (0.153% of total DEXA injections) after DEXA injection, 2 (0.066% of total BROL injections) after BROL injection, and 2 (0.023% of total RAN injections) after RAN injection. Using a student’s t-test, the rate of endophthalmitis for TRIA versus all other medications was statistically significant with a p-value of 0.00152.
Conclusions :
The results of the study show a total incidence rate of 0.036% of endophthalmitis after intravitreal injection. This review suggests that TRIA yielded a significantly higher incidence rate of endophthalmitis as compared to the other medications.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.