Endophthalmitis After Intravitreal Injections: Incidence, Presentation, Management, and Visual Outcome

Abstract

I read with interest the article by Dossarps and associates, 1 Dossarps D. Bron A.M. Koehrer P. Aho-Glele L.S. Creuzot-Garcher C. for the FRCR NET (FRENCH RETINA SPECIALISTS NET)Endophthalmitis after intravitreal injections: incidence, presentation, management, and visual outcome. Am J Ophthalmol. 2015; 160: 17-25 Abstract Full Text Full Text PDF PubMed Scopus (102) Google Scholar in which they reported the results of their multicenter (25 centers) retrospective study, including incidence and characteristics of endophthalmitis after 316 576 intravitreal injections (IVI). Antibiotic prophylaxis was based on topical 1.5% azithromycin for 3 days either before or after IVI; antiseptic prophylaxis, topical 0.05% picloxydine 3 days before and 3 days after IVI. They reported that in univariate analysis, use of an antibiotic or antiseptic was statistically associated with an increased incidence of endophthalmitis (P = .011 and P = .021, respectively). In multivariate analysis, use of prophylaxis with an antibiotic or antiseptic remained statistically associated with an increased incidence of endophthalmitis (interrater reliability = 2.77, 95% confidence interval 1.54–5.00, P = .001). Likewise, they concluded that “the endophthalmitis rate was higher with antibiotic prophylaxis or antiseptic use.” Endophthalmitis After Intravitreal Injections: Incidence, Presentation, Management, and Visual OutcomeAmerican Journal of OphthalmologyVol. 160Issue 1PreviewTo report the incidence and characteristics of endophthalmitis after intravitreal injections of anti–vascular endothelial growth factor agents or corticosteroids and to describe the clinical and bacteriologic characteristics, management, and outcome of these eyes with acute endophthalmitis in France. Full-Text PDF ReplyAmerican Journal of OphthalmologyVol. 160Issue 4PreviewWe thank Dr Grzybowski for his interest in our article.1 In his letter he points out some discrepancies between the text of our article and the content of Table 1. We think the confusion comes from the interpretation of the title of Table 1. We mentioned in the title of Table 1 “Factors influencing the incidence of endophthalmitis after intravitreal injections.” “Influencing” is a neutral wording and should not be interpreted as increasing or decreasing. Therefore, taking into account the sense of “influencing,” we do not think that “Table 1 delivers opposite data,” as stated by our colleague. Full-Text PDF