Culture-positive endophthalmitis 6 hours after intravitreal antibiotics

The purpose of this study was to report culture-positive endophthalmitis after intravitreal antibiotic injection and initial culture-negative tap.

This is an interventional case report of an 84-year-old woman who underwent vitrectomy and intravitreal antibiotic injection. The main outcome measures include resolution of infection, inflammation, and visual acuity improvement.

Endophthalmitis after intravitreal pegaptanib injection was treated initially with a vitreous and aqueous tap and intravitreal antibiotic injection at a satellite clinic, because the patient was seen 5 hours from the nearest retina surgical facility. She subsequently underwent vitrectomy and intravitreal antibiotic injection. The initial culture results were negative and only the second culture was positive for Staphylococcus aureus. One year later, visual acuity was 20/30 after cataract extraction with intraocular lens implantation.

When a suspected endophthalmitis case is seen many hours from a retina surgical facility, it may be best to perform tap and injection of intravitreal antibiotics although vitrectomy surgery may still be required but will be delayed.