Poorer Outcomes Associated With Endophthalmitis Following Intravitreal Injection Than Following Cataract Surgery
Endophthalmitis following intravitreal injection was associated with an increased incidence of Streptococcus infection, earlier presentation, and poorer visual outcomes compared with endophthalmitis following cataract surgery, according to a study published in the British Journal of Ophthalmology.1
Matthew P. Simunovic, MB, BChir, PhD, of Sydney Eye Hospital, Australia, and colleagues conducted a retrospective analysis of 101 patients with acute endophthalmitis following cataract surgery or intravitreal injection who presented between 2007 and 2010. Main outcome measures included identification of the causative organism, time to presentation, odds of improvement in visual acuity follow ing treatment, odds of final visual acuity of counting fingers or less, and odds of enucleation.
Of the study participants, 48 had undergone preceding cataract surgery and 53 had undergone intravitreal injections. The investigators found that there was an increased incidence of Streptococcus species endophthalmitis in patients who had received intravitreal injections (24.53% vs 6.25%; odds ratio [OR] = 5.85; P = .022). Endophthalmitis following intravitreal injection was associated with an increased likelihood of final visual acuity of counting fingers of less (OR = 6.0; P < .01), decreased likelihood of any improvement in visual acuity following treatment (OR = 0.13; P < .01), and an increased likelihood of presenting within a week of the procedure (OR = 3.93; P < .01).
Endophthalmitis caused by Streptococcus organisms was associated with an increased likelihood of a final visual acuity of counting fingers or less (OR = 10.2; P < .01), decreased likelihood of any improvement in visual acuity following treatment (OR = .06; P < .01), and increased likelihood of enucleation (OR = 17.11; P < .01).
- Simunovic MP, Rush RB, Hunyor AP, Chang AA. Endophthalmitis following intravitreal injection versus endophthalmitis following cataract surgery: clinical features, causative organisms, and post-treatment outcomes. Br J Ophthalmol. 2012;96(6):862-866.