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Poor outcomes likely with endophthalmitis after intravitreal injection
Endophthalmitis after intravitreal injection presents earlier and is associated with significantly worse visual outcomes and an increased frequency of Streptococcus spp. infection compared with endophthalmitis after cataract surgery, according to a retrospective case series.
The researchers evaluated the causative organisms, clinical features and visual outcomes of endophthalmitis after intravitreal injection and after cataract surgery. Forty-eight patients who had acute endophthalmitis after cataract surgery and 53 patients who had acute endophthalmitis after intravitreal injection presented to a tertiary referral center between 2007 and 2010; 38 patients were culture negative, and 63 patients were culture positive.
There was an increased incidence of Streptococcus spp. endophthalmitis after intravitreal injection vs. cataract (24.53% vs. 6.25%; P = .022). Mean time to presentation was 4.5 days after intravitreal injection and 7.2 days after cataract surgery.
Endophthalmitis after intravitreal injection and endophthalmitis resulting from Streptococcus spp. were associated with increased likelihood of final visual acuity of counting fingers or less and decreased likelihood of improvement after treatment. Endophthalmitis resulting from Streptococcus spp. also was associated with an increased risk of enucleation.