Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome
Purpose. Postintravitreal injection (IVI) endophthalmitis is a rare but devastating complication. Herein, we report the incidence ,and clinical and microbiological characteristics, as well as the visual outcome, in IVIs endophthalmitis in two medical centers. Methods. All patients undergoing intravi...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2023/9212524 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849738302866849792 |
|---|---|
| author | Bar Davidov Avi Ohayon Omer Trivizki Shulamit Schwartz Shiri Shulman |
| author_facet | Bar Davidov Avi Ohayon Omer Trivizki Shulamit Schwartz Shiri Shulman |
| author_sort | Bar Davidov |
| collection | DOAJ |
| description | Purpose. Postintravitreal injection (IVI) endophthalmitis is a rare but devastating complication. Herein, we report the incidence ,and clinical and microbiological characteristics, as well as the visual outcome, in IVIs endophthalmitis in two medical centers. Methods. All patients undergoing intravitreal injections between 1/2018 and 12/2019 in two large medical centers were analyzed for post-IVI endophthalmitis. Results. Of the total of 51,356 IVIs performed, 23 cases of post-IVI endophthalmitis were diagnosed, yielding an overall incidence of 0.045%. The median interval from IVI to symptoms onset was 2 days (IQR: 1–5). Cultures were positive in 56% of the cases (100% Gram-positive bacteria and 76% coagulase-negative staphylococcus). Parameters associated with higher culture-positive rates included samples taken during vitrectomy, WBC on vitreous smear, the number of IVIs in the 12 months prior to presentation, and the time interval from last IVI to diagnostic sampling. At 6- and 12-month follow-up, the median change in VA (logMAR) was −1.10 (IQR: (−1.32)–(−0.40)) and −1.02 (IQR: (−1.10)–(−0.30)), respectively. Younger age and better BCVA at presentation were associated with better VA outcome, while positive culture result and systemic steroids treatment were each associated with the worse visual outcome. We found no difference in visual outcomes between PPV and TAI as a primary procedure. Conclusion. Post-IVI endophthalmitis is a rare complication, and most patients do not regain their initial VA. Certain parameters (clinical, microbiological, and therapeutic) may help anticipate the outcome and guide decision making regarding diagnosis and treatment. |
| format | Article |
| id | doaj-art-fd467479ac984d8583dda3edbb30555d |
| institution | DOAJ |
| issn | 2090-0058 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-fd467479ac984d8583dda3edbb30555d2025-08-20T03:06:39ZengWileyJournal of Ophthalmology2090-00582023-01-01202310.1155/2023/9212524Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and OutcomeBar Davidov0Avi Ohayon1Omer Trivizki2Shulamit Schwartz3Shiri Shulman4Division of OphthalmologyDivision of OphthalmologyDivision of OphthalmologyDivision of OphthalmologyOpthalmology InstitutePurpose. Postintravitreal injection (IVI) endophthalmitis is a rare but devastating complication. Herein, we report the incidence ,and clinical and microbiological characteristics, as well as the visual outcome, in IVIs endophthalmitis in two medical centers. Methods. All patients undergoing intravitreal injections between 1/2018 and 12/2019 in two large medical centers were analyzed for post-IVI endophthalmitis. Results. Of the total of 51,356 IVIs performed, 23 cases of post-IVI endophthalmitis were diagnosed, yielding an overall incidence of 0.045%. The median interval from IVI to symptoms onset was 2 days (IQR: 1–5). Cultures were positive in 56% of the cases (100% Gram-positive bacteria and 76% coagulase-negative staphylococcus). Parameters associated with higher culture-positive rates included samples taken during vitrectomy, WBC on vitreous smear, the number of IVIs in the 12 months prior to presentation, and the time interval from last IVI to diagnostic sampling. At 6- and 12-month follow-up, the median change in VA (logMAR) was −1.10 (IQR: (−1.32)–(−0.40)) and −1.02 (IQR: (−1.10)–(−0.30)), respectively. Younger age and better BCVA at presentation were associated with better VA outcome, while positive culture result and systemic steroids treatment were each associated with the worse visual outcome. We found no difference in visual outcomes between PPV and TAI as a primary procedure. Conclusion. Post-IVI endophthalmitis is a rare complication, and most patients do not regain their initial VA. Certain parameters (clinical, microbiological, and therapeutic) may help anticipate the outcome and guide decision making regarding diagnosis and treatment.http://dx.doi.org/10.1155/2023/9212524 |
| spellingShingle | Bar Davidov Avi Ohayon Omer Trivizki Shulamit Schwartz Shiri Shulman Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome Journal of Ophthalmology |
| title | Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome |
| title_full | Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome |
| title_fullStr | Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome |
| title_full_unstemmed | Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome |
| title_short | Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome |
| title_sort | postintravitreal injection endophthalmitis incidence characteristics management and outcome |
| url | http://dx.doi.org/10.1155/2023/9212524 |
| work_keys_str_mv | AT bardavidov postintravitrealinjectionendophthalmitisincidencecharacteristicsmanagementandoutcome AT aviohayon postintravitrealinjectionendophthalmitisincidencecharacteristicsmanagementandoutcome AT omertrivizki postintravitrealinjectionendophthalmitisincidencecharacteristicsmanagementandoutcome AT shulamitschwartz postintravitrealinjectionendophthalmitisincidencecharacteristicsmanagementandoutcome AT shirishulman postintravitrealinjectionendophthalmitisincidencecharacteristicsmanagementandoutcome |