title: Meta-analysis of infectious endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents.
abstract: OBJECTIVE
  To investigate the rate of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents, the spectrum of causative organisms, and associated visual acuity outcomes.
  
  
  METHODS
  PubMed articles containing the keywords "endophthalmitis" and "intravitreal" between January 2005 and May 2012 were identified and reviewed. Inclusion criteria included article in English, more than 100 intravitreal anti-VEGF injections, and report of adverse events including endophthalmitis after intravitreal injection.
  
  
  RESULTS
  Forty-three articles were analyzed. Endophthalmitis occurred after 197 of 350,535 intravitreal anti-VEGF injections (0.056%). The most common organisms isolated were coagulase-negative Staphylococcus (38.24%) and Streptococcus species (29.41%).
  
  
  CONCLUSIONS
  The reported rate of endophthalmitis after intravitreal anti-VEGF injection is low. Coagulase-negative Staphylococcus and Streptococcus species were the most frequent causative organisms. Streptococcus species represent the causative organism of endophthalmitis after intravitreal VEGF injections at a higher rate than rates reported in the literature for endophthalmitis following most incisional intraocular surgeries. Among patients with endophthalmitis after intravitreal anti-VEGF injection, endophthalmitis caused by Streptococcus species is associated with poorer visual acuity outcomes than endophthalmitis caused by coagulase-negative Staphylococcus and culture-negative cases.
authors.forename: John B
authors.initials: JB
authors.lastname: Fileta
authors.forename: Ingrid U
authors.initials: IU
authors.lastname: Scott
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D009877:Endophthalmitis / Q000453:epidemiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D058449:Intravitreal Injections; D012164:Retinal Diseases / Q000188:drug therapy; D012307:Risk Factors; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A