Adiel Barak, MD (Tel Aviv, Israel), Anat Loewenstein, MD (Tel Aviv, Israel)

PURPOSE:

Infectious endophthalmitis following intravitreal triamcinolone injections (IVTA) can result in severe loss of vision when treated in a fashion similar to the endophthalmitis vitrectomy Study recommendations. We want to report outcomes of six eyes who developed acute postoperative endophthalmitis following IVTA and were treated with early vitrectomy and intravitreal antibiotics injections.

METHODS:

A retrospective, interventional, case series of all patients with acute postoperative endophthalmitis following IVTA that were treated at the Tel Aviv Medical Center between March 2001 and July 2002.

RESULTS:

Six eyes of six patients with acute postoperative endophthalmitis that appeared after IVTA were identified. The time to presentation was 1 day in 3 patients, and 2-3 months after injection in 3 patients (median 48 days). The most common clinical findings were vitritis (n=6), iritis (n=6), hypopyon (n=3), pain (n=3), red eye (n=6), and decreased vision (n=6). The presenting visual acuity was 1/24- LP. Initial treatment consisted of immediate vitrectomy upon diagnosis and injection of intravitreal antibiotics (n=6). Intraocular cultures yielded identification in four patients. The median postinfection vision was 20/400 (range, 20/60 to no light perception). One patients ended up with no light perception visual acuity, including phthisis (n=1).

CONCLUSION:

Early vitrectomy for acute endophthalmitis following intravitreal triamcinolone acetonide injection may result in better final outcome compare to treatment in a fashion similar to the endophthalmitis vitrectomy Study recommendations.