Real-World Study Compares Favorably to Randomized Controlled Trials for Rates of Suspected Endophthalmitis Post Injection

Real-World Study Compares Favorably to Randomized Controlled Trials for Rates of Suspected Endophthalmitis Post Injection

Researchers conducted a large retrospective review of real-world rates of endophthalmitis after intravitreal anti-VEGF and steroid injections, and found rates were low and similar to those reported rates in actual random controlled trials.

The Study

The study, reported Healio, included a thorough analysis of electronic medical records from Vestrum Health Retina Database, totaling 2.86 million injections with 954 cases of suspected endophthalmitis based on billing codes from January 2013 to March 2018, diagnosed within 14 days of injection. The team evaluated the individual patient rates of administration of aflibercept, bevacizumab, conventional ranibizumab, prefilled ranibizumab, dexamethasone implants, and triamcinolone.

The Results

The researchers found, in 915,786 injections of aflibercept, 420 suspected endophthalmitis cases for a 0.046% rate. They found a 0.24% rate in 1,002,405 injections of bevacizumab and a 0.026% rate in 728,865 injections of conventional ranibizumab. Finally, a rate of 0.053% was found with 128,075 prefilled ranibizumab injections.

Investigator Dilsher S. Dhoot, MD, found triamcinolone had the highest rate with 0.114% resulting in suspected cases of endophthalmitis. It had a statistically higher rate of suspected endophthalmitis than all other medications (P<.05).

Who is Vestrum Health?

The mission of Vestrum Health is to capture the value of electronic clinical health record data for the benefit of physicians and their patients. Vestrum Health has developed an aggregated, longitudinal healthcare database from a demographically diverse sample of physicians that provides significant utility to industry, physicians, and patients in a number areas, including Vestrum’s Health Retina Research data base, which was used for this Real-World study.

What is Endophthalmitis?

It is an inflammation of the interior of the eye. It is a possible complication of intraocular surgeries, particularly cataract surgery, with possible loss of vision and the eye itself. Infectious cause is the most common, and various bacteria and fungi have been isolated as the cause of endophthalmitis. Other causes include penetrating trauma, allergic reaction and retained intraocular foreign bodies.

Lead Research/Investigator

Dilsher S. Dhoot, MD