1. CLINICAL OUTCOMES OF PATIENTS WITH ENDOPHTHALMITIS AFTER DEXAMETHASONE INTRAVITREAL IMPLANT.
- Author
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Samuelson AG, Nahar A, Patel SN, Mahmoudzadeh R, Salabati M, Yu-Chuan Kang E, Hinkle JW, Soares RR, Kuriyan AE, and Garg SJ
- Subjects
- Aged, 80 and over, Angiogenesis Inhibitors therapeutic use, Anti-Bacterial Agents therapeutic use, Dexamethasone therapeutic use, Humans, Intravitreal Injections, Retrospective Studies, Steroids therapeutic use, Endophthalmitis diagnosis, Endophthalmitis drug therapy, Endophthalmitis etiology, Eye Infections, Bacterial diagnosis, Eye Infections, Bacterial drug therapy, Eye Infections, Bacterial etiology
- Abstract
Purpose: To report a case series of endophthalmitis associated with intravitreal dexamethasone injections in a single practice and to discuss the clinical findings and visual outcomes of each case., Methods: All endophthalmitis cases following intravitreal dexamethasone injections performed from January 1, 2014 to October 20, 2020 were identified using Wills Eye/MidAtlantic billing records. The diagnosis, clinical information, and microbiology were confirmed for each case. Data were analyzed using Excel (Microsoft Excel, Redmond, WA)., Results: Four cases of endophthalmitis were identified from 3,925 intravitreal dexamethasone injections in a single practice and one case was referred from an outside institution, resulting in an incidence of 0.102% (1 in 981 injections). Mean age was 82.3 years (range, 63-88 years) with a mean of 11.3 intravitreal dexamethasone injections performed (range, 2-30 injections) before endophthalmitis. Cases presented with endophthalmitis a mean (SD) of 3.6 (1.64) days after causative injection. Three cases grew gram-positive organisms. All patients responded to intravitreal antibiotics. Mean logarithm of the minimal angle of resolution visual acuity at causative injection, endophthalmitis presentation, 3 months, and last follow-up was 0.44 (20/55), 2.22 (20/3,319), 1.18 (20/303), and 1.46 (20/577), respectively., Conclusion: Endophthalmitis following intravitreal steroid injections may occur more frequently than other intravitreal injections. Dexamethasone-attributed endophthalmitis remains uncommon, and prompt intravitreal antibiotic treatment seems to be effective in this series.
- Published
- 2022
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