Meta-analysis of infectious endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents

John B. Fileta, Ingrid U. Scott, Harry W. Flynn

Research output: Contribution to journalArticle

82 Scopus citations

Abstract

BACKGROUND AND 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. PATIENTS AND 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%). CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)143-149
Number of pages7
JournalOphthalmic Surgery Lasers and Imaging Retina
Volume45
Issue number2
DOIs
StatePublished - Jan 1 2014

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology

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