Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Retina. 2021 Jul 1;41(7):1470-1477. doi: 10.1097/IAE.0000000000003050.
Visual outcomes after postinjection endophthalmitis have been well-studied, but the effect of endophthalmitis on the underlying exudative disease process remains unclear. We investigate the need for continued anti-vascular endothelial growth factor injections after endophthalmitis.
Eyes that developed endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor between January 1, 2016, and May 31, 2018, at a single academic retina practice were identified. Retrospective chart review was performed to determine 1) the proportion of eyes without recurrence of macular edema or subretinal fluid after endophthalmitis and 2) the proportion achieving a 12-week or greater interval between anti-vascular endothelial growth factor injections or exudation after endophthalmitis compared with internal controls before endophthalmitis.
Of 50 eyes with endophthalmitis, seven (14.0%) had no fluid recurrence at a mean of 98.1 week. Of 43 eyes with recurrence, 48.0% achieved a >12-week recurrence-free interval after endophthalmitis (vs. 8.3% before endophthalmitis; P < 0.0001). Eyes with compared to those without choroidal neovascularization were more likely to achieve this interval (60.5% vs. 8.3%, respectively; P = 0.002).
Endophthalmitis after anti-vascular endothelial growth factor injection is associated with relative stability of the underlying exudation. Further research is necessary to elucidate the mechanism, which may be useful in developing strategies and targets for the treatment of exudative macular diseases.
注射后眼内炎的视觉预后已得到充分研究,但眼内炎对潜在渗出性疾病过程的影响仍不清楚。我们研究了眼内炎后继续抗血管内皮生长因子注射的必要性。
在单一眼科视网膜诊所,于 2016 年 1 月 1 日至 2018 年 5 月 31 日期间,对接受抗血管内皮生长因子玻璃体内注射后发生眼内炎的眼进行了鉴定。通过回顾性图表审查,确定 1)眼内炎后无黄斑水肿或视网膜下积液复发的比例,2)与眼内炎前的内部对照相比,眼内炎后达到抗血管内皮生长因子注射或渗出物间隔 12 周或更长时间的比例。
50 只眼发生眼内炎,7 只眼(14.0%)在平均 98.1 周时无液体复发。43 只眼有复发,48.0%在眼内炎后达到>12 周无复发间隔(与眼内炎前相比为 8.3%;P<0.0001)。与没有脉络膜新生血管形成的眼相比,达到该间隔的可能性更大(分别为 60.5%和 8.3%;P=0.002)。
抗血管内皮生长因子注射后发生眼内炎与潜在渗出的相对稳定性有关。需要进一步研究以阐明其机制,这可能有助于制定治疗渗出性黄斑疾病的策略和靶点。