Document Detail

Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom: incidence, features, risk factors, and outcomes.
MedLine Citation:
PMID:  23060022     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To describe the incidence, features, management, and risk factors of post-intravitreal anti-VEGF endophthalmitis (PIAE) in patients undergoing treatment for exudative age-related macular degeneration in the United Kingdom.
METHODS: Prospective observational case control study. Forty-seven cases of PIAE were identified through the British Ophthalmological Surveillance Unit from January 2009 to March 2010. Data collected at diagnosis and at 6 months follow-up included patient demographics, intravitreal injection details, pre- and post-injection management, visual acuity, clinical features and management of PIAE, causative organisms, and clinical outcomes. Details were compared with 200 control cases from 10 control centres to identify potential risk factors.
RESULTS: Estimated PIAE was 0.025%. Culture-positive PIAE incidence was 0.015%. Mean age of presentation was 78 years. Mean number of intravitreal injections before PIAE was 5. Mean days to presentation was 5 (range 1-39). Positive microbiology culture was found in 59.6%. The majority of causative organisms were Gram positive (92.8%). Significant risk factors were failure to administer topical antibiotics immediately after the injection (P=0.001), blepharitis (P=0.006), subconjunctival anaesthesia (P=0.021), patient squeezing during the injection (P=0.021), and failure to administer topical antibiotics before anti-VEGF injection (P=0.05).
DISCUSSION: The incidence of PIAE in the United Kingdom is comparable to other studies at a rate of 0.025%. The most common causative organisms were Gram positive. Measures to minimise the risk of PIAE include treatment of blepharitis before injection, avoidance of subconjunctival anaesthesia, topical antibiotic administration immediately after injection with consideration to administering topical antibiotics before injection.
D A M Lyall; A Tey; B Foot; S T D Roxburgh; M Virdi; C Robertson; C J MacEwen
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-10-12
Journal Detail:
Title:  Eye (London, England)     Volume:  26     ISSN:  1476-5454     ISO Abbreviation:  Eye (Lond)     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-13     Completed Date:  2013-05-07     Revised Date:  2014-01-29    
Medline Journal Info:
Nlm Unique ID:  8703986     Medline TA:  Eye (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  1517-26     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Anti-Bacterial Agents / administration & dosage*
Antibodies, Monoclonal, Humanized / administration & dosage,  adverse effects*
Endophthalmitis / chemically induced*,  epidemiology,  therapy
Great Britain / epidemiology
Intravitreal Injections
Macular Degeneration / drug therapy
Middle Aged
Prospective Studies
Risk Factors
Treatment Outcome
Vascular Endothelial Growth Factor A / antagonists & inhibitors*
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Antibodies, Monoclonal, Humanized; 0/Vascular Endothelial Growth Factor A; 2S9ZZM9Q9V/bevacizumab
Comment In:
Eye (Lond). 2013 Dec;27(12):1427-8   [PMID:  24136567 ]
Eye (Lond). 2013 Dec;27(12):1426-7   [PMID:  24136574 ]
Eye (Lond). 2013 Sep;27(9):1110   [PMID:  23807389 ]
Eye (Lond). 2013 Sep;27(9):1109   [PMID:  23807386 ]

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