Posters

Endophthalmitis rates following intravitreal injections at Royal Bournemouth hospital over an eight-year period from 2008 to 2016

Poster Details

First Author: J.Lee UK

Co Author(s):    B. Matthews                             

Abstract Details



Purpose:

Intravitreal injections are the most commonly performed ophthalmological procedure and have become the standard of care for the treatment of a number of retinal conditions. The most serious and potentially devastating complication resulting from intravitreal injections is endophthalmitis. The purpose is to: 1) Determine and compare the rates of post-intravitreal injection endophthalmitis at Royal Bournemouth Hospital (RBH) over an eight-year period from 2008 to 2016. 2) Identify changes in practice and its effect on endophthalmitis rates.

Setting:

Ophthalmology Department of The Royal Bournemouth Hospital, an acute district general hospital in England, UK.

Methods:

The reported rates of post-injection endophthalmitis vary widely. Two meta-analyses have calculated the rate of endophthalmitis after anti-vascular endothelial growth factor (VEGF) injections to be 0.049% (52/105,536; McCannel 2011) and 0.056% (197/350,535; Fileta 2014). The total number of intravitreal injections performed was identified retrospectively from electronic records by the information department. The cases of post-intravitreal injection endophthalmitis were identified from the department’s written logbook record. The percentage rate was then calculated per year.

Results:

• The total number of intravitreal injections performed in RBH has increased year on year from 719 in 2008 to 4045 in 2016. This included both anti-vascular endothelial growth factor (VEGF) and steroid agents. • The post-intravitreal injection endophthalmitis rate ranges from a minimum of 0% in 2016 to a maximum of 0.15% in 2013. The mean annual rate over the eight-year period was 0.08%. • Endophthalmitis rates in %: 2008=0.14, 2009=0.09, 2010=0.12, 2011=0.06, 2012=0.05, 2013=0.15, 2014=0.03, 2015=0.06, 2016=0 • There were no cases of endophthalmitis following intravitreal dexamethasone injections. Key changes in practice at RBH: 2013: Introduction of the diabetic macular oedema (DMO) service following National Institute for Health and Care Excellence (NICE) approval of ranibizumab for treating DMO. 2014: Course of prophylactic chloramphenicol drops post-intravitreal injection stopped 2016: Introduction of nurse injectors

Conclusions:

• Despite the rising number of intravitreal injections being performed each year, the rate of endophthalmitis is not increasing. • Royal Bournemouth Hospital has a mean annual post-intravitreal injection endophthalmitis rate of 0.08% from 2008 to 2016. • Changes in practice at RBH have not adversely affected the rates of endophthalmitis.

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