ABSTRACT
Purpose: To report a case of endophthalmitis associated with Legionella Pneumophila . Case Report: A 46-year-old, highly myopic male with a complex history of recurrent retinal detachments, macular hole, cataract surgery and an infected scleral buckle in the left eye, presented with pain, redness, hypopyon and vision loss in the left eye, 14 days following blunt head trauma. Empirical treatment for endophthalmitis with intravitreal injections of Vancomycin and Ceftazidime afforded minimal improvement. He developed recurrent hypopyon and underwent vitrectomy surgery with intravitreal antibiotic injections at the time of surgery and had improvement. Intraoperative culture was positive for Legionella Pneumophila. He had continued episodes of recurrent inflammation which were quelled by intravitreal moxifloxacin injections performed every 3-10 days. He developed a recurrent RD with proliferative vitreoretinopathy (PVR) and underwent vitrectomy with silicone oil. The retina was reattached but had no light perception vision in the affected eye. Conclusion: When endophthalmitis is contracted in a work-place setting, a culture for L. pneumophila should be considered. A combination of intravitreal moxifloxacin and oral azithromycin may be effective.
ABSTRACT
PURPOSE: To report the transient resurgence of symptomatic silicone oil droplets following intravitreal bevacizumab injections. OBSERVATIONS: We report seven patients presenting with silicone oil droplets following intravitreal bevacizumab injections. These were the first cases noted in 10 years using the same supplier of preloaded syringes in an estimated 90,413 injections performed by 7 physicians. They occurred during a 4 month period (06-10/2016), suggesting they may have been related to a batch or batches of syringes. Symptomatic floaters attributed to the droplets were noted on an average of 6.7 ± 1.5 days following the injection and followed an average of 10.4 ± 3.75 injections over a period of 3.4 ± 1.9 years and resolved in 5 of our 7 patients within 9 months. CONCLUSIONS AND IMPORTANCE: Symptomatic intravitreal silicone oil droplets are a rare complication of intravitreal injections. Symptoms are generally transient and not clinically significant and hence the benefits of treating potentially blinding eye diseases in this fashion appear to outweigh the limited risk of the rare, temporary floaters. The current series may be related to a batch or batches of syringes.
