Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis

Douglas K Sigford,1 Shivani Reddy,1 Christine Mollineaux,2 Shlomit Schaal1 1Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, 2Department of Ophthalmology and Visual Science, University of Kentucky, Lexington, KY, USA Purpose: To report on end...

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Autores principales:	Sigford DK, Reddy S, Mollineaux C, Schaal S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/a4a2974b72a543d09cb9a3cf116194a8
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spelling	oai:doaj.org-article:a4a2974b72a543d09cb9a3cf116194a82021-12-02T05:06:04ZGlobal reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis1177-5483https://doaj.org/article/a4a2974b72a543d09cb9a3cf116194a82015-05-01T00:00:00Zhttp://www.dovepress.com/global-reported-endophthalmitis-risk-following-intravitreal-injections-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Douglas K Sigford,1 Shivani Reddy,1 Christine Mollineaux,2 Shlomit Schaal1 1Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, 2Department of Ophthalmology and Visual Science, University of Kentucky, Lexington, KY, USA Purpose: To report on endophthalmitis occurrence and associated risk factors following the intravitreal injection of anti-VEGF agents based on a review of published literature.Materials and methods: A Medline search was performed using the terms “bevacizumab” and “ranibizumab”. A total of 534 English-language articles of varying design and published from 2006 to November 2013 were analyzed for endophthalmitis occurrence and contributing perioperative factors.Results: A total of 445,503 injections were counted. There were 103 cases of postinjection endophthalmitis in 176,124 injections (0.058%) with bevacizumab (Avastin) versus 79 cases in 269,379 injections (0.029%) with ranibizumab (Lucentis). This difference was due to a significantly higher occurrence of culture-negative endophthalmitis associated with bevacizumab injections. Culture-positive risk was not statistically different between the two drugs. The reported use of postinjection topical antibiotics increased the risk of culture-positive endophthalmitis. No association was found with the use of povidone iodine, a lid speculum, a mask, or an operating room. Streptococcus spp. were the most prevalent causative organism, accounting for nine of 54 (17%) of all culture-positive cases.Conclusion: Reported postinjection endophthalmitis occurred significantly more in patients treated with bevacizumab than those treated with ranibizumab. However, culture-positive occurrence was similar. Despite the potential for contamination at the time of drug compounding, bevacizumab does not appear to confer a higher risk of culture-positive endophthalmitis than ranibizumab. This study also suggests antibiotic use may increase endophthalmitis occurrence. Keywords: endophthalmitis, eye infections, intravitreal injections, panophthalmitisSigford DKReddy SMollineaux CSchaal SDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 773-781 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Sigford DK Reddy S Mollineaux C Schaal S Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis
description	Douglas K Sigford,1 Shivani Reddy,1 Christine Mollineaux,2 Shlomit Schaal1 1Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, 2Department of Ophthalmology and Visual Science, University of Kentucky, Lexington, KY, USA Purpose: To report on endophthalmitis occurrence and associated risk factors following the intravitreal injection of anti-VEGF agents based on a review of published literature.Materials and methods: A Medline search was performed using the terms “bevacizumab” and “ranibizumab”. A total of 534 English-language articles of varying design and published from 2006 to November 2013 were analyzed for endophthalmitis occurrence and contributing perioperative factors.Results: A total of 445,503 injections were counted. There were 103 cases of postinjection endophthalmitis in 176,124 injections (0.058%) with bevacizumab (Avastin) versus 79 cases in 269,379 injections (0.029%) with ranibizumab (Lucentis). This difference was due to a significantly higher occurrence of culture-negative endophthalmitis associated with bevacizumab injections. Culture-positive risk was not statistically different between the two drugs. The reported use of postinjection topical antibiotics increased the risk of culture-positive endophthalmitis. No association was found with the use of povidone iodine, a lid speculum, a mask, or an operating room. Streptococcus spp. were the most prevalent causative organism, accounting for nine of 54 (17%) of all culture-positive cases.Conclusion: Reported postinjection endophthalmitis occurred significantly more in patients treated with bevacizumab than those treated with ranibizumab. However, culture-positive occurrence was similar. Despite the potential for contamination at the time of drug compounding, bevacizumab does not appear to confer a higher risk of culture-positive endophthalmitis than ranibizumab. This study also suggests antibiotic use may increase endophthalmitis occurrence. Keywords: endophthalmitis, eye infections, intravitreal injections, panophthalmitis
format	article
author	Sigford DK Reddy S Mollineaux C Schaal S
author_facet	Sigford DK Reddy S Mollineaux C Schaal S
author_sort	Sigford DK
title	Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis
title_short	Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis
title_full	Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis
title_fullStr	Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis
title_full_unstemmed	Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis
title_sort	global reported endophthalmitis risk following intravitreal injections of anti-vegf: a literature review and analysis
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/a4a2974b72a543d09cb9a3cf116194a8
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Global reported endophthalmitis risk following intravitreal injections of anti-VEGF: a literature review and analysis

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