[Intravitreal triamcinolone acetonide Complication of infectious and sterile endophthalmitis]

Intravitreal triamcinolone acetonide (TA), applied as treatment for various edematous and neovascular ocular diseases, was analyzed for infectious or sterile endophthalmitis and pseudoendophthalmitis.

In a prospective interventional study, 645 eyes were treated with approximately 20 mg intravitreal TA. The removal of the vehicle and the intravitreal injection were performed under sterile conditions. A total of 97 eyes received a second TA injection, 13 a third, 1 a fourth, 2 a fifth, and 1 a sixth injection. The mean follow-up was 7.5 months (median: 5.7 months).

In the 1st week after 759 TA injections, 758 resulted in no hypopyon or Tyndall phenomenon >2(+), but in one eye a pseudoendophthalmitis with hypopyon was present. Anterior chamber lavage demonstrated TA crystals, and the culture was negative. In the 2nd week, one patient developed infectious endophthalmitis after a fall had caused ocular perforation.

Intravitreal TA injections (approximately 20 mg) harbor a low risk of infectious or sterile endophthalmitis and pseudoendophthalmitis, if the injection and vehicle removal are performed under sterile conditions.