title: Current Infectious Endophthalmitis Rates After Intravitreal Injections of Anti-Vascular Endothelial Growth Factor Agents and Outcomes of Treatment.
abstract: OBJECTIVE
  To assess the incidence and outcomes of infectious endophthalmitis after intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents.
  
  
  METHODS
  Patient records at the Bascom Palmer Eye Institute (BPEI) from January 1, 2005, through December 31, 2014, were reviewed. The largest commercial claims and encounters database in the U.S. (MarketScan) was utilized to calculate the population-based endophthalmitis rate for 2011 to 2013.
  
  
  RESULTS
  The population-based rate of endophthalmitis after anti-VEGF injections for 2011 to 2013 was 391/740,757 (0.053%). BPEI's rate was 20/121,285 (0.016%) during the study period: eight after bevacizumab (0.012%), six after ranibizumab (0.018%), and six after aflibercept (0.031%) injection. Nine BPEI cases (45%) were culture-positive: Streptococcus species (5), coagulase-negative Staphylococcus (3), and non-anthracis Bacillus (1). Final visual acuity varied from 20/25 to no light perception.
  
  
  CONCLUSIONS
  Endophthalmitis after anti-VEGF injection was uncommon in our institution and in the population-based database. Treatment outcomes were variable but generally fared better in the culture-negative cases.
authors.forename: Ninel Z
authors.initials: NZ
authors.lastname: Gregori
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Schwartz
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Rosenfeld
authors.forename: Kamyar
authors.initials: K
authors.lastname: Vaziri
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Moshfeghi
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Fortun
authors.forename: Jaclyn L
authors.initials: JL
authors.lastname: Kovach
authors.forename: Sander R
authors.initials: SR
authors.lastname: Dubovy
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Albini
authors.forename: Janet L
authors.initials: JL
authors.lastname: Davis
authors.forename: Audina M
authors.initials: AM
authors.lastname: Berrocal
authors.forename: William E
authors.initials: WE
authors.lastname: Smiddy
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D052157:Aptamers, Nucleotide / Q000627:therapeutic use; D000068258:Bevacizumab / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005431:Florida / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D000069579:Ranibizumab / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012164:Retinal Diseases / Q000188:drug therapy; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D000900:Anti-Bacterial Agents; D052157:Aptamers, Nucleotide; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; C495058:pegaptanib; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab