Purpose: To report the rates, culture results, and visual acuity outcomes of endophthalmitis after intravitreal injection. Methods: Retrospective, consecutive case series of all patients who underwent intravitreal injection at University of Miami - Bascom Palmer Eye Institute between January 1, 2021 and December 31, 2024. Results: Endophthalmitis occurred following intravitreal injection in 3/29,802 (0.010%) eyes in 2021, 4/28,767 (0.014%) in 2022, 2/29,249 (0.004%) in 2023, and 1/27,549 (0.004%) in 2024. The use of ranibizumab decreased with time in the current study while faricimab usage increased. There was a slight increase in aflibercept usage after the approval of high dose 8 mg aflibercept in 2023. Vitreous cultures demonstrated growth of Streptococcus mitis/oralis in 1/10 (10%), Staphylococcus aureus in 1/10 (10%), Granulicatella adiacens in 1/10 (10%), Staphylococcus epidermis in 1/10 (10%), Abiotrophia defectiva in 1/10 (10%), and were negative in 5/10 (50%). The cumulative incidence of endophthalmitis over the 4-year time period was 0.0087% (10/115,367) and was similar to rates reported between 2005 and 2020 at the same institution ( P = 0.48). There were no differences in the rates of endophthalmitis between various medications ( P = 0.32). After treatment, mean best-corrected visual acuity at last follow-up examination was 1.42 logMAR (20/526; range: 20/20 to no light perception). Conclusion: Endophthalmitis is a rare complication of intravitreal injection. In the current study, the incidence of endophthalmitis was similar to previously reported rates and did not differ between agents.
Rohowetz et al. (2026) studied this question.