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Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis
Published on: February 6, 2021
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DELAYED-ONSET STREPTOCOCCUS INTERMEDIUS ENDOPHTHALMITIS FOLLOWING ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR
Gareth D Mercer1, Michael Politis1, Thalmon R Campagnoli1
1Department of Ophthalmology and Visual Sciences, McGill University, Montréal, Canada; and.
Retinal Cases & Brief Reports
|November 9, 2020
Summary
Delayed endophthalmitis from Streptococcus viridans after anti-VEGF injections can occur. Prompt diagnosis and treatment led to a good visual outcome in this case of delayed-onset infection.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Intravitreal anti-VEGF injections are common for exudative age-related macular degeneration.
- Endophthalmitis following these injections is often caused by Streptococcus viridans and can be aggressive.
Observation:
- A 91-year-old woman experienced delayed endophthalmitis 7 weeks post-aflibercept injection.
- Initial symptoms included pain and decreased visual acuity, with initial misdiagnosis as vitreous hemorrhage.
Findings:
- Culture revealed Streptococcus intermedius, a viridans streptococcus, causing the endophthalmitis.
- Vitrectomy with intravitreal antibiotics (vancomycin and ceftazidime) resolved the infection.
Implications:
- This case highlights the potential for atypical, delayed presentations of post-injection endophthalmitis.
- Ophthalmologists should maintain a high suspicion for endophthalmitis even with delayed onset and consider viridans streptococci.
- Despite delayed presentation, good visual outcomes are achievable with prompt management.
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