Real-world rates of suspected endophthalmitis after injections similar to clinical trial rates
CHICAGO — In a large retrospective review of real-world rates of endophthalmitis after intravitreal anti-VEGF and steroid injections, rates were low and similar to reported rates in clinical trials, according to a speaker here.
“The rates were low, similar to reported rates of clinical trials. ... The majority of patients were able to regain vision within the first 2 months following the suspected endophthalmitis,” Dilsher S. Dhoot, MD, said at the American Society of Retina Specialists annual meeting.
The study of electronic medical records from Vestrum Health Retina Database included 2.86 million total injections with 954 cases of suspected endophthalmitis, based on billing codes from January 2013 to March 2018, diagnosed within 14 days of injection. Individual rates for aflibercept, bevacizumab, conventional ranibizumab, prefilled ranibizumab, dexamethasone implants and triamcinolone were evaluated.
Triamcinolone had the highest rate, with 64 of 56,194 injections, or 0.114%, resulting in suspected cases of endophthalmitis. Triamcinolone had a statistically higher rate of suspected endophthalmitis compared with all other medications (P < .05), Dhoot said.
In 915,786 injections of aflibercept, researches found 420 suspected endophthalmitis cases for a 0.046% rate. In 1,002,405 injections of bevacizumab, 236 suspected cases were found for a 0.024% rate. In 728,865 injections of conventional ranibizumab, 193 suspected cases were found for a 0.026% rate. In 128,075 prefilled ranibizumab injections, 26 cases were found for a 0.02% rate. Finally, in 28,188 dexamethasone implants, 15 cases were found for a 0.053% rate.
Bevacizumab and both forms of ranibizumab had statistically significant lower rates of suspected endophthalmitis compared with aflibercept, dexamethasone and triamcinolone (P < .05). – by Robert Linnehan
Dhoot DS. Real-world rates of suspected endophthalmitis following anti-VEGF and steroid intravitreal injections in the United States. Presented at: American Society of Retina Specialists annual meeting; July 27-30, 2019; Chicago.
Disclosure: Dhoot reports he is a consultant for and receives honoraria from Alimera Sciences, Genentech and Regeneron and is on the advisory board of and receives honoraria from Allergan and Santen Pharmaceutical.