Original articleIncidence and Outcomes of Infectious and Noninfectious Endophthalmitis after Intravitreal Injections for Age-Related Macular Degeneration
Section snippets
Methods
This study followed the STROBE checklist items for reporting observational study data.27
Study Population
This study included 4564 patients collectively receiving 88 150 IVTs over 10 years between January 2006 and November 2016. Fifty-three percent of the 4564 patients completed at least 5 years of follow-up, and 8% went on to complete at least 10 years of follow-up. The average number of visits per patient was 22. During the study period, we recorded 18 infectious endophthalmitis and 11 noninfectious endophthalmitis. Two patients developed noninfectious endophthalmitis in both eyes and were
Incidence and Cumulative Rate of Noninfectious Endophthalmitis
Noninfectious endophthalmitis developed in 11 cases of 88 150 injections (1 per 8014 injections [0.012%]; 95% CI, 0.006–0.022). The cumulative rate of noninfectious endophthalmitis per patient increased to 0.087% and 0.228% after 10 and 20 injections, respectively (Table 1 and Fig 1C). Of note, no cases of noninfectious endophthalmitis were recorded in eyes after the 20th injection (Table 1 and Fig 1C). The risk of noninfectious endophthalmitis did not increase significantly with each
Discussion
The FRB! observational database allowed us to assess the incidence of infectious and noninfectious endophthalmitis and VA outcomes over a long period of time. Incidences of infectious endophthalmitis and noninfectious endophthalmitis “per injection” were in the range of previous studies. The prospective design of FRB! registry allowed us to report the median number of IVT before the occurrence of endophthalmitis and the cumulative rate of endophthalmitis “per patient,” which increased over time
Acknowledgments
The Fight Retinal Blindness! Investigators: Eye Associates, Sydney, NSW (Prof M. Gillies, Dr. Adrian Hunt); Canberra Hospital, Garran, ACT (Dr. R. Essex; Dr. C. Dayajeewa); Retina Associates, Chatswood, NSW (Prof A. Hunyor, A/Prof. S. Fraser-Bell, Dr. C. Younan, Dr. A. Fung); Centre for Eye Research Australia, East Melbourne, VIC (Prof R. Guymer, Dr. D. Louis); Marsden Eye Specialists, Parramatta, NSW (Dr. J. Arnold, Dr. D. Chan, Dr. H. Cass); Victoria Parade Eye Consultants, Fitzroy, VIC (Prof
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Financial Disclosure(s): The author(s) made the following disclosures: V.D.: Research grant of the French Society of Ophthalmology.
M.C.G.: Sydney Medical Foundation Fellow; Support − National Health and Medical Research Council practitioner fellowship.
D.B.: Support − Walter and Gertrud Siegenthaler Foundation Zurich, Switzerland, and the Swiss National Foundation.
Supported by grants from the Royal Australian NZ College of Ophthalmologists Eye Foundation (2007-2009), the National Health and Medical Research Council, Australia (2010-2012), and the Macular Disease Foundation, Australia. Funding was provided by Novartis and Bayer. These supporting organizations had no role in the design or conduct of the research.
Author Contributions:
Conception and design: Daien, Nguyen, Essex, Gillies
Data collection: Daien, Morlet, Barthelmes, Gillies
Analysis and interpretation: Daien, Nguyen, Essex
Obtained funding: Not applicable
Overall responsibility: Daien, Nguyen, Essex, Morlet, Barthelmes, Gillies