Sterile Endophthalmitis after Intravitreal Triamcinolone: A Possible Association with Uveitis

Abstract

To report an association between uveitis and sterile endophthalmitis after intravitreal triamcinolone acetonide injection. Retrospective case series. A retrospective analysis of all patients receiving intravitreal triamcinolone injection at the Cole Eye Institute from January 2006 through September 2006 was carried out to evaluate for the occurrence of bacterial or sterile endophthalmitis. Indication for treatment, ocular history, best-corrected Snellen visual acuity, and clinical examination findings were recorded from the clinical charts before injection and at last follow-up. A total of 310 eyes received intravitreal triamcinolone injection for various causes, including age-related macular degeneration (AMD), diabetic retinopathy, vascular occlusion, and cystoid macular edema (CME) resulting from uveitis. There were no cases of culture-positive infectious endophthalmitis. There were six cases (1.9%) of sterile endophthalmitis. Of these six cases, four had prior history of uveitis, whereas only 20 of the 310 cases had a prior history of uveitis. All six patients sought treatment within three days of injection, and all recovered rapidly. Presenting visual acuity was either counting fingers or hand movements. Median best-corrected visual acuity before injection was 20/100(+), whereas median final visual acuity was 20/80(-). Patients with a history of uveitis may be at increased risk of experiencing sterile endophthalmitis resulting from intravitreal triamcinolone injection.