Endophthalmitis Clinical Trial
Official title:
Incidence of Endophthalmitis After Intravitreous Anti-vascular Endothelial Growth Factor Injections Comparison Between Patients Receiving Versus Not Receiving Topical Antibiotics Following the Injections
This is a prospective case series which aims to determine the incidence of endophthalmitis following intravitreous anti-vascular endothelial growth factor (VEGF) injection comparing between eyes receiving post-injection antibiotics drops and those not receiving antibiotics drops treated at Chiang Mai University Hospital between May 2015 and April 2017 (2-year period).
Intravitreous anti-VEGF injection has been the most common procedure performed at eye
clinics worldwide. It becomes the gold standard treatment for many macular diseases, such as
diabetic macular edema and neovascular age-related macular degeneration (AMD). One of the
most serious complication after intravitreous injection is post-injection endophthalmitis.
There is no proven preventive strategy of post-injection endophthalmitis except the use of
povidone iodine. However, a number of physicians around the world prescribe topical
antibiotics after the injection, despite the lack of evidence to support the benefit of
topical antibiotics to prevent the occurence of endophthalmitis. Recently, many large trials
from the US including the Diabetic Retinopathy Clinical Research Network (DRCR.net), the
Comparison of AMD Treatment Trials (CATT) study have reported the incidence of
post-injection endophthalmitis comparing between eyes receiving versus not receiving
post-injection antibiotics, and the results of all studies suggested that topical
antibiotics does not help reduce the incidence of post-injection endophthalmitis. In
addition, the results suggested that eyes receiving antibiotics had higher rate of
endophthalmitis comparing to those not receiving antibiotics. Therefore, a majority of
physicians in the United States have stopped prescribing antibiotics drops following the
injection. However, a majority of physicians in Asia-Pacific region still prescribe
antibiotics drops following the injection (according to the Preferences and Trends (PAT)
survey by the American Society of Retina Specialists in 2014).
Due to the limited evidence from Asian literature whether there is difference between
incidence of endophthalmitis following intravitreous anti-VEGF injection between eyes
receiving antibiotics drops versus not receiving antibiotics drops in the Asian setting, the
investigators conducted this study to determine the incidence of endophthalmitis after
intravitreous anti-VEGF injection, comparing between eyes receiving post-injection
antibiotics versus not receiving. Results from this study would be beneficial to guide an
appropriate practice for physicians in the Asian region.
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Observational Model: Case-Only, Time Perspective: Prospective
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