Bleb-associated infections after intravitreal injection.
OBJECTIVE
The purpose of this study was to describe two cases of bleb-associated infections after intravitreal injection.


METHODS
Case reports of two patients. Case 1: A 41-year-old man with choroidal neovascular membrane received intravitreal injections of ranibizumab. Case 2: A 56-year-old man with cystoid macular edema after retinal detachment surgery received intravitreal triamcinolone acetonide.


RESULTS
In Case 1, the patient developed a culture-negative blebitis 3 days after intravitreal ranibizumab and was treated with intravitreal, subconjunctival, and oral antibiotics. The infection resolved after 3 weeks, with stable 20/100 vision and preservation of bleb function. In Case 2, a bleb-associated endophthalmitis (positive for Streptococcus pneumoniae) occurred 3 weeks after intravitreal triamcinolone acetonide, requiring repeated intravitreal antibiotics and two vitrectomy procedures to control the infection, with final vision of hand motions.


CONCLUSIONS
Bleb-associated infections can be a complication of intravitreal injection. The potentially severe results of bleb-associated endophthalmitis warrant monitoring in patients with previous trabeculectomy who undergo intravitreal injection therapies.
From the Department of Ophthalmology, University of California San Francisco School of Medicine, San Francisco, California.
Somanus
S
Thoongsuwan
Har Hiu
HH
Dawn Lam
Robert B
RB
Bhisitkul