Causative Pathogens of Endophthalmitis after Intravitreal Anti-VEGF Injection: An International Multicenter Study

Ophthalmologica. 2019;241(4):211-219. doi: 10.1159/000496942. Epub 2019 Mar 19.

Abstract

Purpose: The main objective of this study was to investigate the microbiological spectrum of endophthalmitis after anti-VEGF injections and to compare streptococcal with non-streptococcus-associated cases with regard to baseline characteristics and injection procedure.

Methods: Retrospective, international multicenter study of patients with culture-positive endophthalmitis after intravitreal anti-VEGF injection at 17 different retina referral centers.

Results: Eighty-three cases with 87 identified pathogens were included. Coagulase-negative staphylococci (59%) and viridans streptococci (15%) were the most frequent pathogens found. The use of postoperative antibiotics and performance of injections in an operating room setting significantly reduced the rate of streptococcus-induced endophthalmitis cases (p = 0.01 for both).

Conclusion: We found a statistically significant lower rate of postinjectional local antibiotic therapy and operating room-based procedures among the streptococcus-induced cases compared to cases caused by other organisms.

Keywords: Endophthalmitis; Intravitreal injection; Vascular endothelial growth factor.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteria / isolation & purification*
  • Endophthalmitis / drug therapy
  • Endophthalmitis / etiology
  • Endophthalmitis / microbiology*
  • Eye Infections, Bacterial / microbiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections / adverse effects
  • Male
  • Retinal Diseases / drug therapy
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity*
  • Vitreous Body / microbiology*

Substances

  • Anti-Bacterial Agents
  • Vascular Endothelial Growth Factor A