Infectious and presumed noninfectious endophthalmitis after intravitreal triamcinolone acetonide injection

Retina. 2003 Oct;23(5):686-91. doi: 10.1097/00006982-200310000-00014.

Abstract

Purpose: To report potentially distinguishing characteristics between bacterial endophthalmitis and presumed noninfectious endophthalmitis associated with intravitreal triamcinolone acetonide injection.

Methods: Records of two patients with culture-proven bacterial endophthalmitis and six patients with presumed noninfectious endophthalmitis from intravitreal triamcinolone acetonide injections were analyzed retrospectively.

Results: Two eyes in two patients with culture-proven bacterial endophthalmitis had decreased vision and hypopyon or vitritis, but no pain or conjunctival injection 2 weeks after intravitreal triamcinolone acetonide injection. Seven eyes in six patients with presumed noninfectious endophthalmitis had blurred vision, hypopyon, and variable pain all within 2 days of intravitreal triamcinolone injection. All seven eyes were followed up closely and had rapid resolution of hypopyon and symptoms.

Conclusion: Bacterial endophthalmitis after intravitreal triamcinolone acetonide injection may present in an atypical, relatively delayed manner with decreased vision but no pain or redness. Presumed noninfectious endophthalmitis presents within 2 days after the injection, may be accompanied by discomfort, and has a hypopyon that may be the triamcinolone material itself or a sterile inflammatory reaction. In these eyes, the hypopyon and symptoms quickly resolve without treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents
  • Drug Therapy, Combination / therapeutic use
  • Endophthalmitis / chemically induced*
  • Endophthalmitis / drug therapy
  • Endophthalmitis / microbiology
  • Eye Infections, Bacterial / chemically induced*
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology
  • Female
  • Glucocorticoids / adverse effects*
  • Humans
  • Injections
  • Macular Edema / drug therapy
  • Male
  • Middle Aged
  • Pain / etiology
  • Staphylococcal Infections / chemically induced*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Staphylococcus epidermidis / isolation & purification*
  • Time Factors
  • Triamcinolone Acetonide / adverse effects*
  • Vision Disorders / chemically induced
  • Vision Disorders / diagnosis
  • Vision Disorders / microbiology
  • Vitreous Body / drug effects
  • Vitreous Body / microbiology

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • Triamcinolone Acetonide