Micevych Paul S, Fleckenstein Monika, Bernstein Paul S
John A. Moran Eye Center, University of Utah, USA.
Am J Ophthalmol Case Rep. 2025 Jun 28;39:102370. doi: 10.1016/j.ajoc.2025.102370. eCollection 2025 Sep.
To report a case of endophthalmitis presenting one month after intravitreal injection.
An 84-year-old man presented to the retina clinic with vision loss, pain, and redness in his right eye 28 days after a routine intravitreal injection of faricimab for exudative age-related macular degeneration. The patient had a remote history of cataract surgery, rhegmatogenous retinal detachment repair, and scleral buckle explant for exposure 3 years prior. The patient was found to have endophthalmitis, characterized by a hypopyon and dense vitritis. Broad-spectrum intravitreal antimicrobials and dexamethasone were administered, and a vitreous tap returned sterile. The patient achieved initial quiescence, but he had two recurrences of inflammation in this eye over the next 4.5 months. The patient ultimately underwent pars plana vitrectomy, vitreous biopsy, intraocular lens explant, capsulectomy and repeat intravitreal antimicrobial injections for definitive treatment. Broad-range PCR testing detected . Inflammation resolved after surgery without further recurrence in the subsequent 7-month post-operative period.
species have been implicated in cases of endophthalmitis associated with glaucoma filtering surgery and trauma, but this report details a delayed-onset associated endophthalmitis after intravitreal injection.
报告一例玻璃体内注射后1个月出现的眼内炎病例。
一名84岁男性在接受玻璃体内注射法西单抗治疗渗出性年龄相关性黄斑变性28天后，因右眼视力丧失、疼痛和眼红就诊于视网膜诊所。该患者3年前有白内障手术、孔源性视网膜脱离修复术及巩膜扣带暴露取出术的既往史。患者被诊断为眼内炎，表现为前房积脓和浓密的玻璃体炎。给予广谱玻璃体内抗菌药物和地塞米松治疗，玻璃体穿刺抽出物无菌。患者病情最初得到缓解，但在接下来的4.5个月内该眼炎症复发两次。患者最终接受了玻璃体切割术、玻璃体活检、人工晶状体取出术、囊膜切除术及重复玻璃体内抗菌药物注射以进行确定性治疗。广谱聚合酶链反应检测发现……术后炎症消退，在随后的7个月随访期内未再复发。
[具体菌种]已被认为与青光眼滤过手术和外伤相关的眼内炎病例有关，但本报告详细描述了玻璃体内注射后延迟发生的相关性眼内炎。
