Outcome of exudative aged‐related macular degeneration (ARMD) after 3 intravitreal injections of bevacizumab

Creuzot, C; Bidot, M.L.; Souchier, M.; Malvitte, L.; Bron, Am

doi:10.1111/j.1755-3768.2009.3312.x

Cited by 1 publication

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“…However, several reports on large series and systematic reviews have led to the conclusion that antibiotic prophylaxis for IVTs is no longer recommended. The guidelines on the perioperative strategy to minimize the risk of post-IVT endophthalmitis have been updated, and in France a topical antibiotic is no longer recommended after anti-VEGF IVTs . We would probably need a longer observational period to measure the influence of this change in recommendations in France.…”

Section: Discussionmentioning

confidence: 99%

Association of Acute Endophthalmitis With Intravitreal Injections of Corticosteroids or Anti–Vascular Growth Factor Agents in a Nationwide Study in France

Baudin

Benzenine²,

Mariet

et al. 2018

JAMA Ophthalmol

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The number of patients affected by retinal diseases treated with intravitreal injections (IVTs) has resulted in a rapidly growing number of procedures. One of the worst complications after these injections is endophthalmitis.OBJECTIVE To evaluate the incidence of acute endophthalmitis after IVTs of corticosteroids or anti-vascular endothelial growth factor (anti-VEGF) agents. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study included patients undergoing IVTs from January 1, 2012, through December 31, 2015, in France. Data were acquired from the French medical-administrative database (Système National d'Information Inter-Régime de l'Assurance Maladie), which collects hospitalization discharge abstracts and out-of-hospital care information for the whole country. Data were analyzed from March through July 2017. EXPOSURES Intravitreal injections of corticosteroid or anti-VEGF agents. MAIN OUTCOMES AND MEASURES Incidence of acute endophthalmitis within 6 weeks after IVT by means of billing codes from a national database. RESULTS During the study period, 1 811 977 IVTs of corticosteroids or anti-VEGF agents performed on 254 927 patients (60.4% female; median age, 79 years [interquartile range, 70-85 years]) were analyzed. A total of 444 acute endophthalmitis cases (crude incidence, 0.0245%) were recorded. In multivariable analysis, which did not include adjustment for when the endophthalmitis occurred during the study period, the risk of endophthalmitis was lower in male patients (incidence rate ratio [IRR], 0.78; 95% CI, 0.63-0.96; P = .02), higher for corticosteroids than for anti-VEGF agents (IRR, 3.21; 95% CI, 2.33-4.44; P < .001), and higher for nonprefilled syringes of anti-VEGF medications than prefilled syringes for ranibizumab (IRR, 1.63; 95% CI, 1.15-2.30) and aflibercept (IRR, 1.82; 95% CI, 1.25-2.66; P < .001). CONCLUSIONS AND RELEVANCEThe findings from this study of a nationwide database appear to have confirmed the low incidence rate of acute endophthalmitis after IVTs of corticosteroids or anti-VEGF agents. Although an association may not necessarily indicate a cause and effect, the risk for acute endophthalmitis after IVTs appeared to be higher for corticosteroids compared with anti-VEGF agents, while a lower risk of endophthalmitis appeared to be found with prefilled syringes of anti-VEGF medications.

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Section: Discussionmentioning

confidence: 99%