Original articleThe Impact of Prefilled Syringes on Endophthalmitis Following Intravitreal Injection of Ranibizumab
Section snippets
Overview
This multicenter retrospective comparative cohort study was prospectively approved by the Wills Eye Hospital Institutional Review Board as well as institutional review boards at each of the 10 participating centers. The study adhered to the tenets of the Declaration of Helsinki. Billing records were used to retrospectively identify all cases of endophthalmitis secondary to intravitreal injection of 0.5 mg ranibizumab (Genentech, South San Francisco, California, USA) in both conventional vials
Rate of Endophthalmitis
During our study period, a total of 243 754 intravitreal injections of ranibizumab were administered to 43132 unique patients across all 10 institutions. Average patient age was 80.3 years and 61.5% of patients were female. Treatment indication was neovascular AMD for 82.1% of injections, branch retinal vein occlusion (BRVO) 7.9%, central retinal vein occlusion (CRVO) 5.3%, DME 0.5%, and other pathologies 4.2%, including myopic choroidal neovascularization. Overall, a total of 55 patients were
Discussion
Endophthalmitis following intravitreal injection remains an uncommon event. Any prophylaxis measure that might lower the risk of infection requires assessment of a large number of injections in order to achieve adequate power to detect a significantly decreased risk. In our study of 10 institutions across the United States and Japan, we assessed endophthalmitis rates after nearly 250 000 intravitreal ranibizumab injections with detailed confirmation of the diagnosis and clinical course.
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Supplemental Material available at AJO.com.