Endophthalmitis rate low after dexamethasone implant
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NEW YORK — Infectious endophthalmitis after intravitreal dexamethasone implant is rare but more frequent than after anti-VEGF injections, according to a poster presented at the American Society of Retina Specialists annual meeting.
Konstantin Astafurov, MD, PhD, and co-authors retrospectively reviewed the data of patients treated with the dexamethasone (DEX) implant between January 2015 and April 2021; 5,420 implants were administered to 1,591 patients. Indications were retinal vein occlusion, diabetic macular edema and Irvine-Gass syndrome.
Infectious endophthalmitis (IE) developed in eight patients, at the rate of one event per 677 injections (0.148%). All patients were treated with intravitreal antibiotics. Immediate pars plana vitrectomy was required in one case due to light perception vision, and delayed pars plana vitrectomy was performed in another case 4 days after presentation due to worsening infection.
Previous clinical trials and retrospective studies report variable rates of infectious endophthalmitis after dexamethasone implant, ranging from 0.07% to 1.3%, and no specific treatment guidelines have been issued so far, the authors wrote.
“The results of this study suggest an overall low incidence of IE following DEX injection, but higher than that of IE following anti-VEGF injections,” they wrote. “Our data also suggest that the approach to the initial treatment with intravitreal antibiotics is successful in the majority of cases of DEX-associated endophthalmitis, and vitrectomy may be reserved for patients who fail medical intervention.”
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Astafurov K, et al. The incidence and outcomes of infectious endophthalmitis following dexamethasone intravitreal implant. Presented at: American Society of Retina Specialists annual meeting; July 13-16, 2022; New York.
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