Intravitreal Povidone–Iodine Monotherapy as an Alternative Treatment for Exogenous Endophthalmitis in Patients With Antibiotic Allergies

Purpose: To evaluate the outcomes of intravitreal povidone–iodine as an alternative treatment for exogenous endophthalmitis in patients with antibiotic allergies. Methods: This retrospective case series included patients with antibiotic allergies who developed exogenous endophthalmitis and received monotherapy with intravitreal 1.25% povidone–iodine (0.1 mL). Primary outcomes were best-corrected visual acuity (VA) at 3 and 6 months and treatment-related complications. Results: A total of 7 eyes from 7 patients were included. The mean patient age was 72 years, and the mean follow-up duration was 10.5 months. The mean presenting VA was counting fingers at 4 feet (1.83 ± 0.97 logMAR), which improved to 20/160 (0.91 ± 0.99 logMAR, P = .03) at 3 months and to 20/150 (0.89 ± 1.00 logMAR, P = .03) at 6 months. Five patients (71%) regained baseline VA or better. No adverse events occurred, and no patients needed further interventions. Conclusions: Intravitreal injection of 1.25% povidone–iodine (0.1 mL) was well tolerated and was associated with visual improvement in patients with exogenous endophthalmitis.