Endophthalmitis associated with intravitreal Ranbizumab: Microbiology and visual outcomes.

Purpose The purpose of this study was to examine the spectrum of pathogenic organisms isolated from all cases of endophthalmitis identified during an 11 year period (2003-2014) at a single eye unit. The study was undertaken at the Queen Alexandra Hospital in Portsmouth, UK. Methods Eye casualty and theatre data bases (HICCS, Medisoft) were used to capture cases of endophthalmitis. Case notes were reviewed to identify whether an intravitreal tap had been taken and to note visual acuities prior to ranibizumab treatment as well as the best visual acuity achieved post endophthalmitis treatment. Microbiological data was gathered for these cases by using the pathology database (ICE). Results There were 8 cases of endophthalmitis in the 11 year period. All except 1 had an intravitreal tap taken for gram staining and microbiological culture. 4 cultures grew coagulase negative Staphylococcus, 1 grew a Streptococcus species, 1 grew the gram negative organism Haemophilus influenza and 1 culture was sterile. All cases were treated with the intravitreal antibiotics Vancomycin and Ceftazidine. 5 patients had a starting visual acuity 6/12 or better and 3 were 6/18 or worse. Post recovery from endophthalmitis 4 patients had VA of 6/24 or better and 2 had Hand Movements or worse. The patient with the gram negative culture had NPL (no perception of light) vision. Conclusions The proportion of coagulase negative Staphylococci was slightly higher than other published reports. 2 patients had a poor visual outcome of Hand Movements or worse despite treatment with intravitreal antibiotics, one of which had a gram negative culture. However, half of the patients retained a reasonable vision of 6/24 or better. [ABSTRACT FROM AUTHOR]