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Incidence of Acute Endophthalmitis after Intravitreal Antivascular Endothelial Growth Factor Injection in Age-related Macular Degeneration

 Hyo Jin Seong  ;  Young Min Park  ;  Jiwon Kim  ;  Kang Ju Son  ;  Eun Jee Chung 
 Korean Journal of Ophthalmology, Vol.36(5) : 435-442, 2022-10 
Journal Title
Korean Journal of Ophthalmology
Issue Date
Acute Disease ; Angiogenesis Inhibitors ; Endophthalmitis* / diagnosis ; Endophthalmitis* / epidemiology ; Endophthalmitis* / etiology ; Endothelial Growth Factors / therapeutic use ; Humans ; Incidence ; Intravitreal Injections ; Ranibizumab ; Receptors, Vascular Endothelial Growth Factor ; Recombinant Fusion Proteins / adverse effects ; Retrospective Studies ; Vascular Endothelial Growth Factor A ; Visual Acuity ; Wet Macular Degeneration* / complications ; Wet Macular Degeneration* / drug therapy ; Wet Macular Degeneration* / epidemiology
Aflibercept ; Endophthalmitis ; Intravitreal injections ; Macular degeneration ; Ranibizumab
Purpose: Antivascular endothelial growth factor (anti-VEGF) agents are routinely intravitreously injected to treat neovascular age-related macular degeneration (AMD). Postoperative endophthalmitis, a side effect after intravitreal anti-VEGF injection, has been reported to have a low incidence but may threaten vision. In this study, we aimed to analyze the incidence of acute endophthalmitis after intravitreal anti-VEGF injection and associated risk factors in patients with neovascular AMD in South Korea.

Methods: Using the health claims data recorded in the Korean National Health Insurance System database, we identified newly developed neovascular AMD cases from 2010 through 2019. Acute endophthalmitis was defined as a case of invasive treatment for accompanying symptoms. All statistical analyses were performed with a significance level p < 0.05. To find risk factors, we used univariate and multivariable Poisson regression.

Results: The overall incidence of acute endophthalmitis was 0.019% (p = 0.21) during the 10-year period: 0.025% for aflibercept injection and 0.014% for ranibizumab injection. The incidence was higher in metropolitan city residents than in Seoul (incidence rate ratio [IRR], 1.96; 95% confidence interval [CI], 1.02-3.79; p = 0.04) and was higher for aflibercept injections than for ranibizumab injections (IRR, 1.82; 95% CI, 1.17-2.82; p = 0.01). However, in multivariate analysis, only aflibercept injections showed a significant effect on the incidence of acute endophthalmitis (IRR, 1.80; 95% CI, 1.16-2.79; p = 0.01).

Conclusions: The incidence of acute endophthalmitis after intravitreal anti-VEGF injections was generally low, and aflibercept was revealed as a significant risk factor.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Park, Young Min(박영민) ORCID logo https://orcid.org/0000-0002-7593-8461
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