Graefe's Archive for Clinical and Experimental Ophthalmology

, Volume 250, Issue 4, pp 499–505

Endophthalmitis following intravitreal injections

  • Cristina Irigoyen
  • Kimia Ziahosseini
  • George Morphis
  • Theodor Stappler
  • Heinrich Heimann
Retinal Disorders

DOI: 10.1007/s00417-011-1851-1

Cite this article as:
Irigoyen, C., Ziahosseini, K., Morphis, G. et al. Graefes Arch Clin Exp Ophthalmol (2012) 250: 499. doi:10.1007/s00417-011-1851-1

Abstract

Background

To report the clinical features, culture results, management and visual outcome of patients with endophthalmitis following intravitreal injections.

Methods

Retrospective review of all patients with suspected endophthalmitis after intravitreal injections treated with intravitreal antibiotics (teicoplanin and ciprofloxacin) at a referral centre between January 2003 and December 2010.

Results

Nineteen cases that had aqueous or vitreous biopsy were identified. Nine had negative culture. Ten had positive culture; Staphylococcus species in 4/10, Streptococcus species in 4/10, E. coli in 1/10 and gram-negative bacilli in 1/10. Symptoms developed within the first 48 hours in all. One of ten culture-positive cases had no pain on presentation, while 5/9 patients with negative culture reported pain. Initial treatment consisted of intravitreal antibiotics in all cases, 6/19 cases required a second intravitreal antibiotic injection, 4/19 underwent vitrectomy as secondary therapy. At the last follow up, 7/19 patients had visual acuity of 6/18 or better, 9/19 had visual acuity of 6/60 or worse.

Conclusion

The overall numbers of patients with endophthalmitis following intravitreal injections has risen dramatically over the past years. In contrast to earlier reports of multicentre studies, outcome of patients is relatively poor in the current treatment settings. We did not find clinical features useful in identifying cases with negative culture.

Keywords

EndophthalmitisIntravitreal injectionsIntravitreal triamcinoloneAntiVEGF

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Cristina Irigoyen
    • 1
    • 2
  • Kimia Ziahosseini
    • 1
  • George Morphis
    • 1
  • Theodor Stappler
    • 1
  • Heinrich Heimann
    • 1
  1. 1.Link 8z, St Paul’s Eye UnitRoyal Liverpool University HospitalLiverpoolUK
  2. 2.Department of OphthalmologyDonostia HospitalSan SebastiánSpain