Purpose: To compare patients with acute endophthalmitis after intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors vs. steroids.Methods: Retrospective single-center, nonrandomized interventional study from 2013 to 2021.Patients underwent vitreous biopsy before initiating treatment and were divided into the following cohorts: (1) anti-VEGF managed medically (T&I-anti-VEGF), (2) anti-VEGF managed by immediate pars plana vitrectomy (PPV-anti-VEGF), and (3) steroid therapy and managed medically or by pars plana vitrectomy (steroid).Results: A total of 141 patients were analyzed. The steroid cohort demonstrated significantly worse presenting (median = 2.80 logarithm of the minimum angle of resolution [logMAR]; P # 0.01) and final (median = 2.30 logMAR) best-corrected visual acuity compared with T&I-anti-VEGF (presenting: median = 2.00 logMAR; final: median = 0.40 logMAR) and pars plana vitrectomy-anti-VEGF cohorts (presenting: median = 2.30 logMAR; final: median = 0.48 logMAR). There was no significant (P = 0.33) difference in the final best-corrected visual acuity between T&I-anti-VEGF and pars plana vitrectomyanti-VEGF cohorts. There were no significant (P $ 0.63) differences among cohorts in best-corrected visual acuity before acute endophthalmitis diagnosis (T&I-anti-VEGF: median = 0.40 logMAR; pars plana vitrectomy-anti-VEGF: median = 0.40 logMAR; steroid: median = 0.44 logMAR). Microbial cultures revealed similar profiles for all cohorts.Conclusion: Acute endophthalmitis after intravitreal injection steroid therapy had worse outcomes compared with anti-VEGF therapy.
Background and Objectives:
Describe risk factors, findings, and outcomes of acute endophthalmitis (AE) following small-gauge pars plana vitrectomy (PPV).
Patients and Methods:
This was a retrospective single-center, nonrandomized study of post-PPV AE patients from 2013 to 2021. All received vitreous biopsy before treatment. Patients were divided into cohorts: 1) PPV within 3 days of diagnosis (Urgent-PPV), and 2) no urgent PPV (Other-treatment [Tx]). Main outcome was best-corrected visual acuity (BCVA) at 6 months.
Results:
Twenty-one patients were analyzed. Epiretinal membrane was most common indication for PPV (48%). Incidence was 0.074%. Culture-positive rate was 57%. For final BCVA, there was no significant (
P
= 0.85) difference between Urgent-PPV (median = 0.40 logMAR) and Other Tx cohorts (median = 0.35 logMAR). Sclerotomy wounds were not sutured in 71% of patients. Approximately 24% and 38% of patients analyzed had either no tamponade or partial tamponade, respectively.
Conclusion:
Tamponade agents and sclerotomy suturing may be important factors when evaluating post-small-gauge PPV-associated AE. Further studies are necessary for clarification.
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Ophthalmic Surg Lasers Imaging Retina
2023;54:xx–xx.]
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