Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome
Table 2
Demographics, clinical presentation, laboratory findings, and management of 23 post-IVI endophthalmitis cases.
Sex
Female (%)
16/23 (70)
Male (%)
7/23 (30)
Age, median, years (IQR)
74.0 (70–83)
Indication for IVI
Age-related macular degeneration (%)
16/23 (70)
Diabetic macular edema (%)
2/23 (9)
Retinal vein occlusion (%)
2/23 (9)
Pseudophakic cystoid macular edema (%)
1/23 (4)
Multifocal choroiditis (%)
1/23 (4)
Choroidal rupture-related CNV (%)
1/23 (4)
Clinical presentation
Symptoms
Decrease in vision (%)
20/23 (87)
Pain (%)
16/23 (70)
Redness (%)
12/23 (52)
Signs
Corneal edema (%)
8/23 (35)
Anterior chamber cells (%)
23/23 (100)
Fibrin (%)
8/23 (35)
Hypopyon (%)
9/23 (39)
Posterior synechiae (%)
2/23 (9)
Intraretinal hemorrhages (%)
8/23 (35)
Preretinal exudates (%)
8/23 (35)
Vitritis (%)
23/23 (100)
IOP (mmHg), median (IQR)
14 (10–18)
Time intervals
Injection: symptoms onset interval, median, days (IQR)
2 (1–5)
Symptoms onset: 1st procedure interval, median, days (IQR)
1 (0–3)
Injection: 1st procedure interval, median, days (IQR)
4 (2–7)
Laboratory findings
WBC on direct smear
Yes (%)
12/23 (52)
No (%)
11/23 (48)
Culture
Positive (%)
13/23 (57)
PPV sample (%)
10/13 (77)
TAI sample (%)
3/13 (23)
Negative (%)
7/23 (30)
Insufficient sample volume (%)
3/23 (13)
Pathogen (%)
Coagulase-negative staphylococci (CoNS) (%)
11/13 (85)
Staphylococcus epidermidis (%)
10/13 (77)
Staphylococcus simulans (%)
1/13 (8)
Staphylococcus aureus (%)
1/13 (8)
Streptococcus sanguinis (%)
1/13 (8)
Globicatella sanguinis (%)
1/13 (8)
Management
Systemic steroids
Yes (%)
11/23 (48)
No (%)
12/23 (52)
Primary procedure
TAI (%)
11/23 (48)
PPV (%)
12/23 (52)
Second procedure (%)
2/23 (9)
PPV after TAI (%)
1/2 (50)
Seconds PPV (%)
1/2 (50)
CNV: choroidal neovascularization; IOP: intraocular pressure; IQR: interquartile range; IVI: intravitreal injection; PPV: pars plana vitrectomy; TAI: tap and inject. WBC: white blood cells.