Inferior intravitreal injection site associated with a higher incidence of post-injection endophthalmitis

Gowtham Jonna; Daniel B. Roth; Howard F. Fine; H. Matthew Wheatley; Jonathan L. Prenner; Arvin Kheterpal; Suzanne Cohen; William J. Feuer

doi:10.3980/j.issn.1672-5123.2015.5.02

Inferior intravitreal injection site associated with a higher incidence of post-injection endophthalmitis

Gowtham Jonna, Daniel B. Roth, Howard F. Fine, H. Matthew Wheatley, Jonathan L. Prenner, Arvin Kheterpal, Suzanne Cohen, William J. Feuer

Ophthalmology

Research output: Contribution to journal › Article › peer-review

Abstract

AIM: To determine whether inferior injections had a higher incidence of post-injection endophthalmitis than superior injections. The incidence of endophthalmitis is higher for inferior than superior trabeculectomy filtering blebs, possibly due to bacteria pooling in the inferior tear lake. METHODS: A practice-wide database of endophthalmitis cases identified 5 occurring during the two-year study period. A retrospective review of 8 672 injections in 1 121 eyes of 909 patients treated during the same two-year study period was performed in order to assess the injection site location. RESULTS: Five eyes developed presumed infectious endophthalmitis. Eighty percent of endophthalmitis cases were injected inferiorly, even though 84.6% of the total cohort was injected superiorly. The odds ratio of infection associated with inferior injection location is 22.1 (P=0.006). CONCLUSION: Endophthalmitis after intravitreal injection is rare, occurring in only 0.025% of injections overall. Avoiding intravitreal injections in the inferior quadrants may further reduce the rate of endophthalmitis.

Original language	English (US)
Pages (from-to)	750-754
Number of pages	5
Journal	International Eye Science
Volume	15
Issue number	5
DOIs	https://doi.org/10.3980/j.issn.1672-5123.2015.5.02
State	Published - May 8 2015

Keywords

Anti-VEGF therapy
Endophthalmitis
Intravitreal injection site

ASJC Scopus subject areas

Ophthalmology

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Inferior intravitreal injection site associated with a higher incidence of post-injection endophthalmitis. / Jonna, Gowtham; Roth, Daniel B.; Fine, Howard F.; Wheatley, H. Matthew; Prenner, Jonathan L.; Kheterpal, Arvin; Cohen, Suzanne; Feuer, William J.

In: International Eye Science, Vol. 15, No. 5, 08.05.2015, p. 750-754.

Research output: Contribution to journal › Article › peer-review

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abstract = "AIM: To determine whether inferior injections had a higher incidence of post-injection endophthalmitis than superior injections. The incidence of endophthalmitis is higher for inferior than superior trabeculectomy filtering blebs, possibly due to bacteria pooling in the inferior tear lake. METHODS: A practice-wide database of endophthalmitis cases identified 5 occurring during the two-year study period. A retrospective review of 8 672 injections in 1 121 eyes of 909 patients treated during the same two-year study period was performed in order to assess the injection site location. RESULTS: Five eyes developed presumed infectious endophthalmitis. Eighty percent of endophthalmitis cases were injected inferiorly, even though 84.6% of the total cohort was injected superiorly. The odds ratio of infection associated with inferior injection location is 22.1 (P=0.006). CONCLUSION: Endophthalmitis after intravitreal injection is rare, occurring in only 0.025% of injections overall. Avoiding intravitreal injections in the inferior quadrants may further reduce the rate of endophthalmitis.",

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AU - Jonna, Gowtham

AU - Roth, Daniel B.

AU - Fine, Howard F.

AU - Wheatley, H. Matthew

AU - Prenner, Jonathan L.

AU - Kheterpal, Arvin

AU - Cohen, Suzanne

AU - Feuer, William J.

PY - 2015/5/8

Y1 - 2015/5/8

N2 - AIM: To determine whether inferior injections had a higher incidence of post-injection endophthalmitis than superior injections. The incidence of endophthalmitis is higher for inferior than superior trabeculectomy filtering blebs, possibly due to bacteria pooling in the inferior tear lake. METHODS: A practice-wide database of endophthalmitis cases identified 5 occurring during the two-year study period. A retrospective review of 8 672 injections in 1 121 eyes of 909 patients treated during the same two-year study period was performed in order to assess the injection site location. RESULTS: Five eyes developed presumed infectious endophthalmitis. Eighty percent of endophthalmitis cases were injected inferiorly, even though 84.6% of the total cohort was injected superiorly. The odds ratio of infection associated with inferior injection location is 22.1 (P=0.006). CONCLUSION: Endophthalmitis after intravitreal injection is rare, occurring in only 0.025% of injections overall. Avoiding intravitreal injections in the inferior quadrants may further reduce the rate of endophthalmitis.

AB - AIM: To determine whether inferior injections had a higher incidence of post-injection endophthalmitis than superior injections. The incidence of endophthalmitis is higher for inferior than superior trabeculectomy filtering blebs, possibly due to bacteria pooling in the inferior tear lake. METHODS: A practice-wide database of endophthalmitis cases identified 5 occurring during the two-year study period. A retrospective review of 8 672 injections in 1 121 eyes of 909 patients treated during the same two-year study period was performed in order to assess the injection site location. RESULTS: Five eyes developed presumed infectious endophthalmitis. Eighty percent of endophthalmitis cases were injected inferiorly, even though 84.6% of the total cohort was injected superiorly. The odds ratio of infection associated with inferior injection location is 22.1 (P=0.006). CONCLUSION: Endophthalmitis after intravitreal injection is rare, occurring in only 0.025% of injections overall. Avoiding intravitreal injections in the inferior quadrants may further reduce the rate of endophthalmitis.

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KW - Endophthalmitis

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Inferior intravitreal injection site associated with a higher incidence of post-injection endophthalmitis

Abstract

Keywords

ASJC Scopus subject areas

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