Endophthalmitis after intravitreal injections. Incidence, management and prognosis.
OBJECTIVE
To assess the rate of endophthalmitis after intravitreal injection (IVI) in a «clean room» of a single health centre, following the guidelines of the Spanish Vitreo-Retinal Society (SERV). An analysis was performed on the culture specimens, response to treatment, and final outcomes (guidelines).


METHODS
A retrospective, observational study was conducted on a consecutive case series of patients diagnosed with infectious endophthalmitis after IVI in a single health centre between 2010 and 2015. Intravitreal and systemic treatment was given following the SERV guidelines. The patients were followed up the case was resolved.


RESULTS
There were 5 cases of endophthalmitis out of 9467 IVI (incidence 0.053%). Positive cultures were obtained in aqueous and/or vitreous fluid in all cases, with Staphylococcus epidermidis being involved in 4 out of 5 cases. In 2 cases, final visual acuity was non-light perception due to intractable retinal detachments after resolution of the infectious process.


CONCLUSIONS
IVI performed in a «clean room» have a low incidence of endophthalmitis. The most common infectious agent was Staphylococcus species. In 2 cases the functional prognosis was poor.
Servicio de Oftalmología, Hospital Universitari Son Espases, Palma de Mallorca (Islas Baleares), España. Electronic address: Ramon.tarrago@ssib.es.
R
R
Tarragó
Servicio de Oftalmología, Hospital Universitari Son Espases, Palma de Mallorca (Islas Baleares), España.
J L
JL
Olea
Servicio de Oftalmología, Hospital Universitari Son Espases, Palma de Mallorca (Islas Baleares), España.
C
C
Ramírez
Servicio de Oftalmología, Hospital Universitari Son Espases, Palma de Mallorca (Islas Baleares), España.
L
L
Escudero
D000369:Aged, 80 and over; D001766:Blindness / Q000209:etiology; D003131:Combined Modality Therapy; D048909:Diabetes Complications; D009877:Endophthalmitis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000209:etiology; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections / Q000009:adverse effects*; D008297:Male; D008837:Micrococcus; D008875:Middle Aged; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D045828:Moraxellaceae Infections / Q000209:etiology; D011379:Prognosis; D012163:Retinal Detachment / Q000209:etiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D014640:Vancomycin / Q000627:therapeutic use; D014821:Vitrectomy
D014640:Vancomycin
Anti-vascular endothelial growth factor; Antivascular Endothelial Growth Factor; Endoftalmitis; Endophthalmitis; Intravitreal injection; Inyección intravítrea; Staphylococcus; Vancomicina; Vancomycin; Vitrectomy; Vitrectomía