Gil-Martínez M, Rodríguez-Cid M J, Fenández-Rodríguez M I, Blanco-Teijero M J, Abraldes M J, Bandín Vilar E, Zarra-Ferro I, González-Barcia M, Gómez-Ulla F, Fernández-Ferreiro A
Servicio de Oftalmología, Hospital de Conxo, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España; Instituto Oftalmológico Gómez-Ulla, Santiago de Compostela, La Coruña, España.
Servicio de Oftalmología, Hospital de Conxo, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Santiago de Compostela, La Coruña, España.
Arch Soc Esp Oftalmol (Engl Ed). 2020 May;95(5):211-216. doi: 10.1016/j.oftal.2020.01.019. Epub 2020 Mar 8.
Analyze clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal antivascular endothelial growth factor.
Observational retrospective case series of patients with sterile endophthalmitis following anti-VEGF intravitreal injections. Clinical data of patients treated with intravitreal anti-VEGFs during one year have been revised. Those who have presented an episode of sterile endophthalmitis are analyzed and their causality and management are studied.
Seven patients have had a sterile endophthalmitis onset within 4days after intravitreal injection (aflibercept n=5 and ranibizumab n=2). These patients have some active neovascular condition: age related macular degeneration (n=4), myopic choroidal neovascularization (n=1) or macular edema: diabetic macular edema (n=1), branch retinal vein occlusion (n=1). Shared signs and symptoms included painless vision loss, anterior chamber and vitreous cell and lack of hypopyon. In all patients, visual acuity returned to within one line of baseline acuity.
Differentiating cases of sterile from infectious endophthalmitis may be challenging. It is crucial to differentiate both entities as a good diagnosis determines the visual prognosis. We should be aware of minimal inflammation after repeated intravitreal injections in order to establish the adequate treatment.
分析与玻璃体内抗血管内皮生长因子相关的无菌性眼内炎患者的临床特征、治疗及预后。
抗血管内皮生长因子玻璃体内注射后发生无菌性眼内炎患者的观察性回顾性病例系列研究。回顾了一年内接受玻璃体内抗血管内皮生长因子治疗患者的临床资料。对发生无菌性眼内炎的患者进行分析，并研究其因果关系及治疗情况。
7例患者在玻璃体内注射后4天内发生无菌性眼内炎（阿柏西普5例，雷珠单抗2例）。这些患者存在一些活动性新生血管病变：年龄相关性黄斑变性（4例）、近视性脉络膜新生血管（1例）或黄斑水肿：糖尿病性黄斑水肿（1例）、视网膜分支静脉阻塞（1例）。共同的体征和症状包括无痛性视力丧失、前房和玻璃体有细胞以及无前房积脓。所有患者的视力均恢复到基线视力的一行以内。
区分无菌性眼内炎和感染性眼内炎病例可能具有挑战性。区分这两种情况至关重要，因为准确的诊断决定视力预后。我们应注意反复玻璃体内注射后的轻微炎症，以便确定适当的治疗方法。
