Baudin F, et al. - Researchers assessed the incidence of acute endophthalmitis following intravitreal injections (IVTs) of corticosteroids or anti–vascular endothelial growth factor (anti-VEGF) agents. The low incidence rate of acute endophthalmitis after IVTs of corticosteroids or anti-VEGF agents was confirmed in the findings. Nonetheless, a cause and effect may not necessarily be indicated by an association, the risk for acute endophthalmitis after IVTs for corticosteroids appeared to be higher than anti-VEGF agents. With prefilled syringes of anti-VEGF medications, a lower risk of endophthalmitis was found.

Methods

• Experts conducted a population-based cohort study that included patients undergoing IVTs from January 1, 2012, through December 31, 2015, in France.
• They acquired the data from the French medical-administrative database (Système National d’Information Inter-Régime de l’Assurance Maladie), which collects hospitalization discharge abstracts and out-of-hospital care information for the whole country.
• They analyzed the data from March through July 2017.
• Exposures included the intravitreal injections of corticosteroid or anti-VEGF agents.
• Incidence of acute endophthalmitis within 6 weeks after IVT by means of billing codes from a national database was included in the main outcomes and measures.

Results

• During the study period, they analyzed 1,811,977 IVTs of corticosteroids or anti-VEGF agents performed on 254,927 patients (60.4% female; median age, 79 years [interquartile range, 70-85 years]).
• As per data, a total of 444 acute endophthalmitis cases (crude incidence, 0.0245%) were recorded.
• The risk of endophthalmitis was lower in male patients (incidence rate ratio [IRR], 0.78; 95% CI, 0.63-0.96;P=.02), higher for corticosteroids than for anti-VEGF agents (IRR, 3.21; 95% CI, 2.33-4.44;P < .001), and higher for nonprefilled syringes of anti-VEGF medications than prefilled syringes for ranibizumab (IRR, 1.63; 95% CI, 1.15-2.30) and aflibercept (IRR, 1.82; 95% CI, 1.25-2.66;P < .001); as seen in the multivariable analysis, which did not include adjustment for when the endophthalmitis occurred during the study period.