PURPOSE

To evaluate outcomes of eyes that developed endophthalmitis after intravitreal anti-vascular endothelial growth factor injections that were managed without microbiologic cultures.

DESIGN

Retrospective, single-center, comparative cohort study.

METHODS

We included all eyes with postinjection endophthalmitis from July 1, 2013, to September 1, 2019. Endophthalmitis cases were divided into the culture group if treated with intravitreal antibiotics and a vitreous or aqueous tap sent for microbiologic sampling or into the no culture group if treated with immediate injection of intravitreal antibiotics with an anterior chamber paracentesis that was not sent for microbiologic sampling. The main outcome measures were visual acuity, the incidence of retinal detachment, and the need for additional procedures.

RESULTS

Of 165 endophthalmitis cases identified, 119 (72%) were in the culture group and 46 (28%) were in the no culture group. At endophthalmitis presentation, eyes in the culture group had a mean logMAR VA of 1.98 (∼20/1900) compared with 1.90 (∼20/1600) for eyes in the no culture group (P = .589). At the 6-month follow-up, the mean vision loss was 5.5 lines lost from baseline for the culture group compared with 2.5 lines lost for the no culture group (P = .017). Eyes in the culture group required a subsequent pars plana vitrectomy in 29 of 119 cases (24%) compared with 7 of 46 cases (15%) in the no culture group (P = .29). Six of 119 eyes (5%) in the culture group developed secondary retinal detachments compared with none in the no culture group (P = .143).

CONCLUSIONS

When access to microbiologic facility is not available, the management of postinjection endophthalmitis using intravitreal antibiotics without microbiologic cultures may be an acceptable treatment strategy.

中文翻译：

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玻璃体内抗血管内皮因子注射后的眼内炎：没有微生物培养的眼睛的结果

目的

评估在没有微生物培养的情况下进行玻璃体内抗血管内皮生长因子注射后发生眼内炎的眼睛的结果。

设计

回顾性、单中心、比较队列研究。

方法

我们纳入了从 2013 年 7 月 1 日到 2019 年 9 月 1 日所有注射后眼内炎的眼睛。如果用玻璃体内抗生素和玻璃体或房水水龙头进行微生物取样治疗，眼内炎病例被分为培养组，如果接受治疗，则被分为无培养组立即注射玻璃体内抗生素并进行前房穿刺术，但未送去进行微生物取样。主要结果测量是视力、视网膜脱离的发生率以及是否需要额外的程序。

结果

在确定的 165 例眼内炎病例中，培养组 119 例（72%），未培养组 46 例（28%）。在眼内炎出现时，培养组的眼睛的平均 logMAR VA 为 1.98（~20/1900），而未培养组的眼睛为 1.90（~20/1600）（P  = .589）。在 6 个月的随访中，文化组的平均视力损失比基线损失 5.5 线，而无文化组的平均视力损失为 2.5 线（P  = .017）。培养组 119 例中有 29 例（24%）的眼睛需要随后进行平坦部玻璃体切除术，而未培养组 46 例中有 7 例（15%）（P  = .29）。培养组 119 只眼中有 6 只（5%）出现继发性视网膜脱离，而未培养组则没有（P = .143)。

结论

当无法使用微生物设施时，在没有微生物培养的情况下使用玻璃体内抗生素治疗注射后眼内炎可能是一种可接受的治疗策略。