CLINICAL OUTCOMES OF ACUTE ENDOPHTHALMITIS AFTER INTRAVITREAL DELIVERY OF VASCULAR ENDOTHELIAL GROWTH FACTOR...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Infectious Diseases

Background:

• Intravitreal injections of vascular endothelial growth factor (VEGF) inhibitors and steroids are common treatments for various retinal conditions.
• Acute endophthalmitis is a rare but serious complication following intravitreal injections, potentially leading to vision loss.

Purpose of the Study:

• To compare the visual outcomes of patients who developed acute endophthalmitis after receiving intravitreal vascular endothelial growth factor (VEGF) inhibitors versus steroid injections.

Main Methods:

• A retrospective, single-center study analyzed 141 patients from 2013 to 2021 with acute endophthalmitis post-intravitreal injection.
• Patients were categorized into three cohorts: anti-VEGF managed medically (T&I-anti-VEGF), anti-VEGF managed by immediate pars plana vitrectomy (PPV-anti-VEGF), and steroid therapy (steroid).
• Vitreous biopsy was performed before treatment initiation for all patients.

Main Results:

• The steroid cohort exhibited significantly worse presenting and final best-corrected visual acuity (BCVA) compared to both anti-VEGF cohorts (P ≤ 0.01).
• No significant difference in final BCVA was observed between the T&I-anti-VEGF and PPV-anti-VEGF cohorts (P = 0.33).
• Pre-diagnosis BCVA and microbial culture profiles were similar across all treatment groups.

Conclusions:

• Acute endophthalmitis following intravitreal steroid injections is associated with poorer visual outcomes compared to those treated with anti-VEGF agents.
• The choice between medical management and pars plana vitrectomy for anti-VEGF-related endophthalmitis did not significantly impact final visual acuity.