PIAE risk minimized by additional treatment

Treatment of blepharitis before injection, avoidance of subconjunctival anaesthesia and topical antibiotic administration immediately after injection all contribute to minimizing the risk of contracting post-intravitreal anti-VEGF endophthalmitis (PIAE), claims a study in Eye.

Dr D. A. Lyall et al., Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK, conducted a prospective observational case control study on 47 patients with PIAE.

Patients were identified through the British Ophthalmological Surveillance Unit from January 2009 to March 2010 and data was gathered at diagnosis and at six months follow-up. The measures included patient demographics, intravitreal injection details, pre- and post-injection management, visual acuity, clinical features and management of PIAE, causative organisms and clinical outcomes. All subjects were compared to 200 control participants from 10 control centres to determine potential risk factors.

Positive microbiology culture was discovered in 59.6% of patients and the majority of causative organisms were Gram positive. The significant risk factors included failure to administer topical antibiotics immediately after the injection, blepharitis, subconjunctival anaesthesia, patient squeezing during the injection and failure to administer topical antibiotics before anti-VEGF injection.

The abstract can be viewed here.