Abstract
Purpose :
To evaluate the incidence, clinical features, and outcomes of patients who developed endophthalmitis following intravitreal Injection (IVI) of anti-vascular endothelial growth factor medications.
Methods :
Data was collected from all patients who developed post-IVI endophthalmitis from March 2015 to November 2022 at Austin Retina Associates. Visual acuity (VA) outcomes were evaluated at 3 and 6-months post-infection.
Results :
A total of 249,117 intravitreal injections and 73 post-IVI endophthalmitis patients were included, giving an overall infection rate of 1 in 2954 injections (0.025%). Average patient age was 74.1 years (range 29-95) and 61.9% were female. Patients received an average of 19.5 IVIs prior to development of endophthalmitis (range 1-70). Patients presented an average of 3.2 days after IVI. Visual acuity returned to baseline or improved for 28 patients (44.4%) at 3-months and 29 patients (46.0% at 6-months). Rates of endophthalmitis were 1 in 5439 (0.018%) for bevacizumab, 1 in 6316 (0.016%) for ranibizumab, and 1 in 3273 (0.031%) for aflibercept with no significant difference found between medications (p=0.15). No significant differences in 3-month visual outcomes were found between medications (p=0.42), age at time of injection (p=0.53), number of prior injections (p=0.48), or time to presentation (p=0.77).
Conclusions :
Endophthalmitis is a rare but potentially devastating complication of intravitreal injection and occurs after approximately 1 in 2954 injections. No difference in rates of infection were found between medications and no specific clinical features correlated with clinical outcomes.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.