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EndophthalmitisIntravitreal InjectionsVitreous BodyEye Infections, BacterialInjectionsVitrectomyTriamcinolone AcetonideEye Injuries, PenetratingVisual AcuityCataract ExtractionEye Infections, FungalInjections, IntraocularBacillaceae InfectionsMacular EdemaAngiogenesis InhibitorsEye Foreign BodiesAntibodies, Monoclonal, HumanizedAqueous HumorRetinaEye InjuriesElectroretinographyFluorescein AngiographyLaser CoagulationTriamcinoloneChoroidal NeovascularizationEye DiseasesPhacoemulsificationPanophthalmitisEye EviscerationRetinal DetachmentRabbitsFundus OculiRetinal Vein OcclusionStaphylococcus epidermidisEyeDiabetic RetinopathyLenses, IntraocularOphthalmologic Surgical ProceduresStreptococcus mitisGlucocorticoidsMacular DegenerationSilicone OilsTomography, Optical CoherenceRetinal NeovascularizationRetinal DiseasesLens Implantation, IntraocularAnti-Bacterial AgentsEye InfectionsStaphylococcal InfectionsGram-Positive Bacterial InfectionsRetinitisDrug ContaminationPostoperative ComplicationsOphthalmoscopyCandidiasisVascular Endothelial Growth Factor AWet Macular DegenerationPosterior Eye SegmentUveitisVitreoretinopathy, ProliferativeVitreous HemorrhageGlaucoma, NeovascularEye EnucleationIntraocular PressureAdministration, OphthalmicAnterior ChamberOphthalmic SolutionsPovidone-IodineRetinal Hemorrhage
InjectionsFollowed by intravitreal injectionAntibioticsPostoperativeOcularCataract surgeryEndogenousVancomycinRate of endophthalmitisBevacizumabCulture-positive endophthalmitisRisk of EndophthalmitisRetinaComplicationImplantFungal endophthalmitisReceived an intravitreal injectionClinicalOutcomesPatientsPost-injection endophthalmitisMacularAvastinRates of endophthalmitisVitrectomy StudyPosttraumatic endophthalmitisRanibizumabInflammationOphthalmicBacterial infectionPars0.05 mLPostcataractTreatmentAureus
Injections33
Followed by intravitreal injection1
  • INTERVENTION: Patients underwent a vitreous biopsy followed by intravitreal injection of antibiotics (0.2 mg vancomycin and 0.05 mg gentamicin) and 400 microg dexamethasone or placebo. (eyehospital.nl)
Antibiotics16
  • There were also investigations evaluating intravitreal antibiotics injection using sulfanilamide and penicillin to treat endophthalmitis in the 1940s, yet due to the inconsistency of results and safety concerns, this form of drug delivery was only for experimental use and not applied in patients. (wikipedia.org)
  • The damage to the small blood vessels there causes leakage of fluid Pseudophakic cystoid macular edema Macular edema secondary to retinal vein occlusion Macular edema secondary to uveitis Infections, such as endophthalmitis and retinitis Noninfectious vitritis Sometimes, an intravitreal injection of antibiotics and steroids is given as part of routine cataract surgery. (wikipedia.org)
  • The first use of intravitreal antibiotics was dated back to experiments in the 1940s, in which penicillin and sulfonamides were used to treat the rabbit endophthalmitis models. (wikipedia.org)
  • Later, more studies proved the beneficial effects of intravitreal antibiotics on acute postoperative endophthalmitis. (wikipedia.org)
  • Intravitreal antibiotics then has gradually become the major treatment to manage bacterial endophthalmitis. (wikipedia.org)
  • PURPOSE: To study whether intravitreal dexamethasone as adjuvant to intravitreal antibiotics improves the outcome in patients with suspected postoperative bacterial endophthalmitis. (eyehospital.nl)
  • After 3-4 days the intravitreal injection of antibiotics and dexamethasone or placebo was repeated. (eyehospital.nl)
  • CONCLUSION: This small prospective, placebo-controlled series showed a trend towards a better visual outcome in patients with suspected bacterial endophthalmitis when treatment with intravitreal antibiotics was combined with intravitreal dexamethasone. (eyehospital.nl)
  • After 3-4 days the intravitreal injection of antibiotics and dexamethasone or placebo was repeated.PRIMARY OUTCOME MEASURE: Snellen visual acuity at 3 and 12 months after treatment.RESULTS: In 20/29 patients (69%) the vitreous cultures were positive. (eyehospital.nl)
  • Bacterial endocarditis initially should be treated empirically with intravenous vancomycin and an aminoglycoside or a third-generation cephalosporin, but the use of intravenous antibiotics alone is insufficient for endogenous endophthalmitis. (aafp.org)
  • To salvage ocular function, concurrent therapy with intravitreal antibiotics is recommended, often with an emergent vitrectomy. (aafp.org)
  • The decision to use intravitreal antibiotics or vitrectomy depends on the patient's vision at the time of diagnosis and overall hemodynamic condition. (aafp.org)
  • Ophthalmologists are "very reliant on compounding pharmacies, not just for Avastin but for all preservative-free formulations and intravitreal antibiotics," said Goldberg, who was working at the University of Miami when the outbreak occurred. (medpagetoday.com)
  • We treat serious intraocular infections called endophthalmitis with intravitreal antibiotics. (barraquer.com)
  • The treatments involve Pars Plana Vitrectomy (PPV) or intravitreal broad-spectrum antibiotics with vitreous tap/biopsy (VTB). (biomedcentral.com)
  • There is continuing debate regarding the safety, efficacy, and necessity of intracameral antibiotics to prevent postoperative endophthalmitis. (medscape.com)
Postoperative8
  • PATIENT POPULATION: Twenty-nine consecutive patients with suspected postoperative bacterial endophthalmitis within 6 weeks of cataract surgery. (eyehospital.nl)
  • Pars plana vitrectomy and silicone oil insertion may have a protective effect against the development of postoperative endophthalmitis in eyes receiving KPro. (hindawi.com)
  • Source of pathogens is the ocular surface (e.g., in postoperative, keratitis-related, and bleb-related endophthalmitis) or the environment (e.g., in posttraumatic endophthalmitis). (eophtha.com)
  • 6 In a retrospective study of 170 culture-positive postoperative endophthalmitis cases in India, 21.8% of cases were due to fungi. (eophtha.com)
  • 7 The postoperative fungal endophthalmitis is usually seen due to use of contaminated intraocular irrigation solution, intraocular lenses, ventilation system, hospital construction activities or surgeries conducted in rural settings or eye camps. (eophtha.com)
  • The main objectives of this retrospective multi-center study were to evaluate the rate, risk factors, functional outcome and prognosis of RD after surgical treatment of patients with severe acute exogenous postoperative endophthalmitis having no BCVA exclusion criteria. (biomedcentral.com)
  • Postoperative endophthalmitis is a rare and devastating ocular entity. (biomedcentral.com)
  • Postoperative endophthalmitis, although very rare, is one of the most serious, sight-threatening complications of ocular surgery. (medscape.com)
Ocular10
  • If not properly treated, bacterial endophthalmitis can result in complete vision loss and persistent ocular pain. (medscape.com)
  • Bacterial endophthalmitis is an ocular emergency, and urgent treatment is required to reduce the potential of significant visual loss. (medscape.com)
  • In March 2012, several cases of probable and laboratory-confirmed fungal endophthalmitis occurring after invasive ocular procedures were reported nationwide. (cdc.gov)
  • Our Susvimo (ranibizumab injection) for Intravitreal Use Via Susvimo Ocular Implant Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. (rxlist.com)
  • For Intravitreal Use via SUSVIMO ocular implant. (rxlist.com)
  • Endophthalmitis refers to the inflammation of the ocular cavities and their immediate adjacent structures without extension beyond the sclera, usually secondary to infection. (annals.edu.sg)
  • Endophthalmitis is a potentially devastating ocular disease that may lead to permanent loss of vision. (eophtha.com)
  • Whatever form it may assume, endophthalmitis, which usually occurs with purulent inflammation of the intraocular fluids, such as the vitreous and the aqueous humor, is a serious and dangerous ocular condition, and can be very challenging for the vitreoretinal surgeon, because visibility can be severely compromised due to corneal edema, anterior chamber cells and non-transparent vitreous [ 6 ]. (biomedcentral.com)
  • Endophthalmitis typically causes severe ocular ache and decreased vision. (msdmanuals.com)
  • Ophthalmological risk with the intraocular injection (all intravitreal treatments): active or suspected ocular or periocular infection, severe blepharitis, history of endophthalmitis, history of retinal detachment, myopathy, glaucoma. (who.int)
Cataract surgery7
  • 4,5 The frequency of endophthalmitis after cataract surgery and trauma ranges from 0.07% to 0.13% and 2.4 to 17%, respectively, as previously reported in the literature. (eophtha.com)
  • This population was evaluated for the rate of retinal detachment after 23G Pars Plana Vitrectomy for endophthalmitis following cataract surgery or intravitreal injection. (biomedcentral.com)
  • The reasons for endophthalmitis were previous cataract surgery in 78 patients and following intravitreal injection in 38 patients. (biomedcentral.com)
  • Despite mounting evidence that routine prophylaxis with intracameral cefuroxime and moxifloxacin reduce the endophthalmitis rate following cataract surgery, many surgeons have not adopted this practice. (medscape.com)
  • With the significant increase in cataract surgery volume because of population aging worldwide, effective endophthalmitis prophylaxis is a rising global imperative. (medscape.com)
  • Along with aseptic surgical protocols, the use of perioperative povidone iodine and isolation of the eyelids and eyelashes with proper draping are effective in limiting the incidence of endophthalmitis after cataract surgery. (medscape.com)
  • New data from several large retrospective clinical studies add to the evidence that routine intracameral antibiotic prophylaxis significantly reduces the endophthalmitis rate following cataract surgery. (medscape.com)
Endogenous12
Vancomycin1
  • D. Intravitreal ceftazidime and vancomycin. (aafp.org)
Rate of endophthalmitis2
Bevacizumab3
  • In the Miami endophthalmitis outbreak, Goldberg said 12 patients arrived in the ophthalmic emergency department within 6 days of getting an intravitreal injection of bevacizumab - nine of them arrived within 48 hours of having the shots. (medpagetoday.com)
  • Incidence of presumed silicone oil droplets in the vitreous cavity after intravitreal bevacizumab injection with insulin syringes. (rcophth.ac.uk)
  • Additionally, the odds of developing endophthalmitis were higher with aflibercept injection compared to bevacizumab. (farabiretina.com)
Culture-positive endophthalmitis2
Risk of Endophthalmitis1
  • Appropriate conjunctiva management and early detection with surgical repair of conjunctival retractions or erosions may reduce the risk of endophthalmitis. (rxlist.com)
Retina3
  • Intravitreal injection was first mentioned in a study in 1911, in which the injection of air was used to repair a detached retina. (wikipedia.org)
  • published the first guidelines for intravitreal injection in the journal 'Retina', fomivirsen was still the only medication licensed by the FDA for intravitreal injection. (wikipedia.org)
  • E arly diagnosis of fungal endophthalmitis is important in order to prevent irreversible damage to the retina and prevent visual loss. (eophtha.com)
Complication4
Implant8
  • Question What is the incidence of endophthalmitis following dexamethasone intravitreal implant (DEX) injection? (jamanetwork.com)
  • The purpose of this review article is to provide a comprehensive review of the current applications of intravitreal DEX implant (Ozurdex ® , Allergan Inc, Irvine, CA) for a variety of ophthalmic conditions - ranging from FDA approved indications to off-label uses. (dovepress.com)
  • Intravitreal dexamethasone implant (DEX implant, Ozurdex ® , Allergan Inc, Irvine, CA) is a rod-shaped implant made of a solid biodegradable polymer (Novadur™, Allergan Inc, Irvine, CA) designed to release 700 micrograms of preservative-free dexamethasone over a period of 180 days. (dovepress.com)
  • Non-bioerodible intravitreal implant containing 0.18 mg fluocinolone acetonide in a drug delivery system. (nih.gov)
  • YUTIQ ® (fluocinolone acetonide intravitreal implant) 0.18 mg is indicated for the treatment of chronic non-infectious uveitis affecting the posterior segment of the eye. (nih.gov)
  • In clinical trials, 2.0% of patients receiving a ranibizumab implant experienced at least one episode of endophthalmitis [see CONTRAINDICATIONS, WARNINGS AND PRECAUTIONS]. (rxlist.com)
  • SUSVIMO (ranibizumab injection) is supplied as a sterile, clear to slightly opalescent, colorless to pale brown solution for intravitreal use via the SUSVIMO implant. (rxlist.com)
  • AIM: To evaluate effectiveness of dexamethasone intravitreal implant 0.7 mg (DEX) monotherapy in the AUSSIEDEX study non-responder subgroup, defined by diabetic macular oedema (DME) refractory to anti-vascular endothelial growth factor (anti-VEGF) agents. (bvsalud.org)
Fungal endophthalmitis10
  • Fungal endophthalmitis is a rare but serious infection. (cdc.gov)
  • We describe 2 concurrent multistate outbreaks of fungal endophthalmitis associated with intraocular use of contaminated products labeled as sterile from a single compounding pharmacy. (cdc.gov)
  • On March 5, 2012, the Healthcare Associated Infections Program of the California Department of Public Health was alerted to a cluster of 9 cases of fungal endophthalmitis, all among patients at the same Los Angeles County ambulatory surgical center who had undergone pars plana vitrectomies during October-December 2011. (cdc.gov)
  • the others had a clinical diagnosis of fungal endophthalmitis. (cdc.gov)
  • Fungal endophthalmitis also causes a red eye with photophobia and vision loss. (aafp.org)
  • However, fungal endophthalmitis though rare has a poor prognosis and usually diagnosed late. (eophtha.com)
  • The incidence of fungal endophthalmitis has increased in recent years, particularly in developing countries. (eophtha.com)
  • Patients are usually treated as bacterial infections and would have received steroids before they are diagnosed to have fungal endophthalmitis. (eophtha.com)
  • The prognosis of fungal endophthalmitis depends on the magnitude of intraocular involvement, the virulence of the organism, and the timing of treatment. (eophtha.com)
  • Corticosteroids are, however, contraindicated in fungal endophthalmitis. (msdmanuals.com)
Received an intravitreal injection1
  • We identified 47 cases in 9 states: 21 patients had been exposed to the intraocular dye Brilliant Blue G (BBG) during retinal surgery, and the other 26 had received an intravitreal injection containing triamcinolone acetonide. (cdc.gov)
Clinical7
  • Objective To report the incidence of culture-proven endophthalmitis in a single vitreoretinal practice over the course of 3 years and describe the clinical outcomes associated with each case of endophthalmitis. (jamanetwork.com)
  • Main Outcomes and Measures Development of endophthalmitis following DEX and the clinical management and outcomes of each case of endophthalmitis. (jamanetwork.com)
  • Astellas Pharma Inc. announced positive 24-month topline results from the Phase 3 GATHER2 (NCT04435366) clinical trial evaluating the efficacy and safety of avacincaptad pegol (ACP) intravitreal solution (Izervay, Iveric Bio), a complement C5 inhibitor for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD) . (ophthalmologytimes.com)
  • According to the company, GATHER-2 was a randomly, double-masked, sham-controlled, multicenter Phase 3 clinical trial to evaluate the safety and efficacy of intravitreal administration of avacincaptad pegol (ACP) in 448 enrolled patients with GA secondary to AMD. (ophthalmologytimes.com)
  • The first clinical evidence of endophthalmitis was present in median 5 days after the triggering intervention. (biomedcentral.com)
  • To describe the incidence, clinical characteristics, and treatment outcomes of endophthalmitis after pars plana vitrectomy (PPV) with recycled single-use devices. (biomedcentral.com)
  • Several additional large, international retrospective clinical studies found a significant reduction in endophthalmitis rates with intracameral antibiotic prophylaxis. (medscape.com)
Outcomes5
  • To compare the outcomes of immediate pars plana vitrectomy (PPV) and tap and inject in eyes with postcataract surgery endophthalmitis. (lww.com)
  • To identify the incidence of endophthalmitis and visual outcomes in eyes with Boston type 1 keratoprosthesis combined with pars plana vitrectomy and silicone oil insertion (KPro + PPV + SOI) as compared to eyes receiving Boston type 1 keratoprosthesis (KPro) alone. (hindawi.com)
  • Neither early nor late vitrectomy improved visual outcomes, and seven patients lost the eye completely in the endophthalmitis outbreak that occurred in Miami in July 2011, Roger Goldberg, MD, of the New England Eye Center at Tufts University, and colleagues reported at the American Academy of Ophthalmology meeting. (medpagetoday.com)
  • Despite apparently equivalent therapeutic outcomes, intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy offers significantly higher financial reward for physicians over pars plana vitrectomy (PPV), which could lead to bias in choosing the most appropriate treatment for diabetic retinopathy. (aao.org)
  • According to the Endophthalmitis Vitrectomy Study (EVS), [ 1 ] visual outcomes are often poor. (medscape.com)
Patients8
  • In this study, we report our observation that patients with KPro combined with pars plana vitrectomy and silicone oil insertion have a lower incidence of infectious endophthalmitis than those with KPro alone. (hindawi.com)
  • Following the intravitreal injection, patients should be monitored for elevation in intraocular pressure and for endophthalmitis. (nih.gov)
  • Goldberg told MedPage Today that with the rise of expensive, branded intravitreal anti-VEGF agents that come in appropriate doses, such as ranibizumab (Lucentis), the "need for Avastin syringes safely aliquoted from 4- or 16-mL vials into the tiny doses used in the eye has further increased our reliance on compounding pharmacies and the critical role they play in the care of our patients. (medpagetoday.com)
  • Genentech) unit dose syringes on March 18, 2013 after five patients were diagnosed with serious endophthalmitis associated with the use of the product. (empr.com)
  • Patients should be instructed to report without delay any symptoms suggestive of endophthalmitis. (drugs.com)
  • Since then, it has become a routine practice to refer patients with Klebsiella bacteraemia to the ophthalmology service for endophthalmitis screening, independent of visual symptoms. (annals.edu.sg)
  • In this retrospective study data of endophthalmitis patients from the departments of ophthalmology at the university clinic of Hamburg Eppendorf and the university clinic of the Eberhard Karls in Tübingen, Germany were evaluated. (biomedcentral.com)
  • Medical charts of patients who developed endophthalmitis after PPV were retrospectively reviewed and reported in a descriptive manner. (biomedcentral.com)
Post-injection endophthalmitis3
  • Dr Garg presented data from a recent retrospective study that evaluated universal face mask use on post-injection endophthalmitis rates, a practice that has increased during the COVID-19 pandemic. (ophthalmology360.com)
  • Writing committee for the Post-Injection Endophthalmitis Study Group, Patel SN, Tang PH, et al. (ophthalmology360.com)
  • Intravitreal injection of anti-vascular endothelial growth factor agents is the most common intraocular procedure worldwide, inevitably causing more cases of post-injection endophthalmitis. (springeropen.com)
Macular4
  • It is used to treat various eye diseases, such as age-related macular degeneration (AMD), diabetic retinopathy, and infections inside the eye such as endophthalmitis. (wikipedia.org)
  • At the end of the year, on December 17, the first intravitreal anti-VEGF drug pegaptanib (Macugen) was also licensed by FDA for treatment of wet age-related macular degeneration (wet AMD). (wikipedia.org)
  • A retrospective cost and profit analysis of selected literature, including two years of data from the DRCR Network Protocols W and AB as well as the PANORAMA trial, assessed the potential benefits and financial incentives of an intravitreal aflibercept-based therapy versus PPV for diabetic retinopathy without macular edema (DME) using mean profitability per procedure minute for primary comparison. (aao.org)
  • ACP intravitreal solution was approved by the FDA last month for the treatment of GA secondary to age-related macular degeneration (AMD) and is currently under review by the European Medicines Agency. (ophthalmologytimes.com)
Avastin1
Rates of endophthalmitis3
Vitrectomy Study1
Posttraumatic endophthalmitis1
  • When the inflammation is severe, systemic and periocular therapy may be used in non-cataract-induced, delayed onset, filtering bleb-associated, and posttraumatic endophthalmitis. (medscape.com)
Ranibizumab4
  • Supplemental treatment with 0.5 mg intravitreal ranibizumab injection may be administered in the affected eye if clinically necessary. (rxlist.com)
  • To investigate predictive factors for retreatment after intravitreal ranibizumab injection as first-line treatment for retinopathy of prematurity (ROP). (jkos.org)
  • The medical records of consecutive infants diagnosed with type 1 ROP from 2013 to 2021 who received 0.2 mg intravitreal ranibizumab as their first treatments were retrospectively reviewed. (jkos.org)
  • Intravitreal ranibizumab was injected into 44 eyes of 44 infants. (jkos.org)
Inflammation3
  • Intravitreal injection is used to inject a drug into the eye to reduce inflammation (anti-inflammatory), inhibit the growth and development of new blood vessels (angiostatic), or lower the permeability of blood vessels (anti-permeability), in turn curing various eye diseases. (wikipedia.org)
  • Endophthalmitis is inflammation of the intraocular cavities and is often caused by infection ( 1 ). (cdc.gov)
  • In this study, endophthalmitis was defined clinically by the presence of inflammation of the posterior segment with or without anterior chamber inflammation. (annals.edu.sg)
Ophthalmic1
  • For ophthalmic intravitreal injection. (nih.gov)
Bacterial infection1
  • Endophthalmitis is an acute panuveitis resulting most often from bacterial infection. (msdmanuals.com)
Pars2
0.05 mL2
  • The recommended dose for BEOVU is 6 mg (0.05 mL of 120 mg/mL solution) administered by intravitreal injection monthly (approximately every 25 to 31 days) for the first three doses, followed by 6 mg (0.05 mL) by intravitreal injection once every 8 to 12 weeks. (guidelinecentral.com)
  • The recommended dose for BEOVU is 6 mg (0.05 mL of 120 mg/mL solution) administered by intravitreal injection every six weeks (approximately every 39-45 days) for the first five doses, followed by 6 mg (0.05 mL) by intravitreal injection once every 8-12 weeks. (guidelinecentral.com)
Postcataract1
Treatment2
  • However, the approach to the treatment of endophthalmitis is not consistently agreed upon by vitreoretinal surgeons for all stages of visual acuity. (biomedcentral.com)
  • Endophthalmitis is a medical emergency because vision prognosis is directly related to the time from onset to treatment. (msdmanuals.com)
Aureus1