Outcomes after intravitreal anti-vascular endothelial factor
A Study was conducted to evaluate the outcomes of eyes that developed endophthalmitis after intravitreal anti-vascular endothelial growth factor injections that were managed without microbiologic cultures.

Endophthalmitis cases were divided into the “culture group” if treated with intravitreal antibiotics and a vitreous or aqueous tap sent for microbiologic sampling or into the “no culture group” if treated with immediate injection of intravitreal antibiotics with an anterior chamber paracentesis that was not sent for microbiologic sampling.

--Of 165 endophthalmitis cases identified, 119 were in the “culture group” and 46 were in the “no culture group”.

--At endophthalmitis presentation, eyes in the “culture group” had a mean logMAR VA of 1.98 compared to 1.90 for eyes in the “no culture group”.

--At 6 month follow-up, mean vision loss was 5.5 lines lost from baseline for the “culture group” compared to 2.5 lines lost for the “no culture” group.

--Eyes in the “culture group” required a subsequent pars plana vitrectomy in 29/119 cases compared to 7/46 cases in the “no culture group”.

--6 of 119 eyes in the “culture group” developed secondary retinal detachments compared to 0 in the “no culture group”.

Conclusively, when access to microbiologic facility is not available, management of post-injection endophthalmitis using intravitreal antibiotics without microbiologic cultures may be an acceptable treatment strategy.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0002939421004256?dgcid=rss_sd_all