Intravitreal injection analysis at the Bascom palmer eye institute: Evaluation of clinical indications for the treatment and incidence rates of endophthalmitis

Objective: To report the incidence of endophthalmitis, in addition to its clinical and microbiological aspects, after intravitreal injection of vascular-targeting agents. Methods: A retrospective review of a consecutive series of 10,142 intravitreal injectionsof vasculartargeting agents (bevacizumab, ranibizumab, triamcinolone acetonide, andpreservative-free triamcinolone acetonide) between June 1, 2007 and January 31, 2010,performedby a single service (TGM) at the Bascom Palmer Eye Institute. Results: One case of clinically-suspected endophthalmitis was identified out of a total of 10,142injections (0.009%), presenting within three days of injection of bevacizumab. The case wasculture-positive for Staphylococcus epidermidis. Final visual acuity was 20/40 after pars planavitrectomy surgery. Conclusions: In this series, the incidence of culture-positive endophthalmitis after intravitrealinjection of vascular agents in an outpatient setting was very low. We believe that following astandardized injection protocol, adherence to sterile techniques and proper patient follow-upare determining factors for low incidence rates.