A French population-based study evaluated the incidence of acute endophthalmitis after intravitreal injections of corticosteroids or anti-vascular endothelial growth factor (anti-VEGF) agents. The study found that the risk of endophthalmitis was higher for patients who received steroid injections than for those who received anti-VEGF agents. A lower risk of endophthalmitis was also found with the use of prefilled syringes of anti-VEGF medications.

Researchers analyzed 1,811,977 intravitreal injections performed on 254,927 patients and found 444 acute endophthalmitis cases. In multivariate analysis, which did not include adjustment for the time endophthalmitis occurred during the study period, the risk of endophthalmitis was lower in male patients and higher for corticosteroids than for anti-VEGF agents. The risk was also higher for non-prefilled syringes of anti-VEGF medications than for prefilled syringes of ranibizumab and aflibercept.

Researchers conclude that the findings from this study appear to have confirmed the low incidence rate of acute endophthalmitis after intravitreal injections of the two types of treatment.

Baudin F, Benzenine E, Mariet A, et al. Association of acute endophthalmitis with intravitreal injections of corticosteroids or anti–vascular growth factor agents in a nationwide study in France. JAMA Ophthalmol.September 13, 2018. [Epub ahead of print]