title: Intravitreal injections at the Massachusetts Eye and Ear Infirmary: analysis of treatment indications and postinjection endophthalmitis rates.
abstract: OBJECTIVE
  To report the incidence rate of acute postoperative endophthalmitis secondary to therapeutic intravitreal injections.
  
  
  METHODS
  A retrospective review of all consecutive eyes after intravitreal injections was performed at the Massachusetts Eye and Ear Infirmary, Boston, from 1 January 2007 to 31 December 2011.
  
  
  RESULTS
  During the 5-year study interval, 10 208 intravitreal injections were performed. The overall incidence rate of endophthalmitis was 0.029% per injection (3 of 10 208 injections). In the three cases, in our series, the endophthalmitis occurred at an average of seven injections, which lies within the SD of the mean number of injections received by each eye in this study, suggesting approximately equal probability of infection for each eye after receiving multiple, sequential injections. Bacterial cultures and Gram stain revealed coagulase-negative Staphylococcus species (n=1), moderate bacteria with negative culture (n=1) and moderate Staphylococcus epidermidis (n=1). All cases were successfully treated using either intravitreal antibiotics and steroids or pars plana vitrectomy. Best-corrected visual acuity reduction was not clinically significant at the last visit (>7 months for all cases).
  
  
  CONCLUSIONS
  Acute endophthalmitis is a rare potential complication after intravitreal injection. Further studies are required to elucidate the best prophylactic and aseptic techniques to prevent this rare complication.
authors: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA. englander.miri@gmail.com
authors: Miriam
authors: M
authors: Englander
authors: Teresa C
authors: TC
authors: Chen
authors: Eleftherios I
authors: EI
authors: Paschalis
authors: Joan W
authors: JW
authors: Miller
authors: Ivana K
authors: IK
authors: Kim
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000208:Acute Disease; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D052157:Aptamers, Nucleotide / Q000008:administration & dosage; D000068258:Bevacizumab; D009877:Endophthalmitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections / Q000706:statistics & numerical data*; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D011183:Postoperative Complications; D000069579:Ranibizumab; D012164:Retinal Diseases / Q000145:classification / Q000188:drug therapy*; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D000900:Anti-Bacterial Agents; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide; D000069579:Ranibizumab