The Auckland Endophthalmitis Study

Abstract

Purpose: To report on the incidence and management of endophthalmitis following intravitreal bevacizumab in Auckland, New Zealand. Method: A survey of facilities in Auckland performing intravitreal bevacizumab between January 2007 and December 2014 was undertaken. The clinical notes of patients presenting with bevacizumab-related endophthalmitis were analyzed. Results: During the study period, 39 657 intravitreal bevacizumab injections were performed, with 21 patients undergoing treatment for bevacizumab-related endophthalmitis. The incidence of endophthalmitis was 0.053% (1 per 1888 injections). Most patients (76%) were treated within 4 hours from admission to hospital. Fifteen patients received vitreous tap and inject as primary treatment. From 2013 onward, there was a trend toward vitrectomy surgery as the primary intervention, with 72% of cases receiving vitrectomy as first-line treatment. Those who underwent vitrectomy were more likely to return a culture-positive result ( P = .030). After treatment, the majority of patients displayed an improvement in visual acuity (67%). Conclusion: Endophthalmitis is a rare complication of intravitreal bevacizumab treatment, with an incidence of 1 per 1888 injections in our region. There has been a shift favoring primary vitrectomy surgery in the treatment of endophthalmitis, with those undergoing vitrectomy more likely to return a positive culture result.