Anatomic and Visual Outcomes of Noninfectious Endophthalmitis after Intravitreal Triamcinolone

• Published in: American journal of ophthalmology 2009-06, Vol.147 (6), p.1031-1036
• Main Authors: Yoon, Steven J, Rhee, David Y, Marx, Jeffrey L, Blaha, Gregory R, Rogers, Adam H, Baumal, Caroline R, Reichel, Elias, Duker, Jay S
• Format: Article
• Language: English
• Subjects: Antibiotics; Biological and medical sciences; Endophthalmitis - chemically induced; Endophthalmitis - diagnosis; Endophthalmitis - physiopathology; Follow-Up Studies; Fovea Centralis - pathology; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Humans; Injections; Macular Edema - drug therapy; Macular Edema - etiology; Medical sciences; Miscellaneous; Ophthalmology; Pain; Retrospective Studies; Tomography; Tomography, Optical Coherence; Treatment Outcome; Triamcinolone Acetonide - administration & dosage; Triamcinolone Acetonide - adverse effects; Ultrasonic imaging; Veins & arteries; Visual Acuity - physiology; Vitreous Body
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2008.12.034

Purpose To describe the anatomic and visual outcomes of patients in whom noninfectious endophthalmitis developed after injection of intravitreal triamcinolone acetonide. Design Retrospective case series. Methods Ophthalmologic evaluations of patients in whom noninfectious endophthalmitis developed after intravitreal triamcinolone took place on the day of injection, at the time of presentation of noninfectious endophthalmitis, at the time of clearance of inflammation, and on follow-up examination. Seventeen eyes of 17 patients were identified from 2 institutions. Noninfectious endophthalmitis was identified based on history of visual loss immediately or soon after injection, lack of ocular pain, hypopyon, anterior or vitreous inflammation, and triamcinolone crystals present in the anterior or posterior chambers. Main outcome measures were Snellen visual acuity (VA) and mean foveal thickness by optical coherence tomography. Results Mean VA and mean foveal thickness on the day of injection of intravitreal triamcinolone were 20/132 (logarithm of the minimum angle of resolution [logMAR], 0.82 ± 0.45) and 432 ± 118 μm, respectively. Mean VA at time of noninfectious endophthalmitis (mean, 1.9 days after injection) was 20/4444 (logMAR, 2.35 ± 0.98). At last follow-up (mean, 57.6 days), VA and mean foveal thickness were 20/56 (logMAR, 0.44 ± 0.30) and 301 ± 71 μm, respectively. Conclusions VA and mean foveal thickness in all patients with noninfectious endophthalmitis after intravitreal triamcinolone improved to better than preinjection levels in this series. At last follow-up, no patient had sustained visual loss from noninfectious endophthalmitis. Noninfectious endophthalmitis after intravitreal triamcinolone may not exclude good visual and anatomic prognoses.