ABSTRACT
BACKGROUND AND OBJECTIVE: Bevacizumab requires compounding for off-label intravitreal injection, thus creating a risk of possible contamination during preparation. PATIENTS AND METHODS: This retrospective, consecutive case series from a single site included patients who developed culture-proven acute endophthalmitis after intravitreal injection with contaminated bevacizumab. All patients suspected of endophthalmitis had vitreous biopsy and microbial cultures prior to initiation of treatment and were managed with immediate tap and injection of antibiotics followed early by pars plana vitrectomy. Main outcome measures included best-corrected visual acuity (BCVA) at 3-month follow-up after treatment. RESULTS: Twenty-four patients developed acute bacterial endophthalmitis following intravitreal injection of contaminated bevacizumab single-dose syringes in a single day. Twenty-three cases (95.8%) grew Streptococcus species and one (4.2%) grew Enterococcus species. Six cases (25.0%) had optic nerve atrophy, three (12.5%) developed retinal detachment, one (4.2%) had vitreous hemorrhage, and one (4.2%) had band keratopathy. At 3-month follow-up, compared to BCVA at the time of initial presentation, 11 patients (45.8%) had improved vision, eight (33.3%) had unchanged BCVA, and five (20.8%) had worse BCVA. However, when compared to BCVA prior to endophthalmitis (baseline), 22 cases (91.7%) had significantly worse BCVA at 3-month follow-up. CONCLUSIONS: Contamination of off-label bevacizumab poses devastating risk of endophthalmitis following intravitreal injection. Vigilance is needed to ensure all possible safeguards are in place to prevent contamination. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:346-352.].
Subject(s)
Bevacizumab/adverse effects , Endophthalmitis/drug therapy , Eye Infections, Bacterial/drug therapy , Visual Acuity , Acute Disease , Angiogenesis Inhibitors/administration & dosage , Angiogenesis Inhibitors/adverse effects , Bacteria/isolation & purification , Bevacizumab/administration & dosage , Endophthalmitis/diagnosis , Endophthalmitis/etiology , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/etiology , Female , Follow-Up Studies , Humans , Intravitreal Injections/adverse effects , Male , Middle Aged , Retinal Diseases/drug therapy , Retrospective Studies , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Vitreous Body/microbiologyABSTRACT
OBJECTIVE: we aimed to investigate the changes in thyroid hormones, lipid profile and anthropometric measures after programmed weight loss in Palestinian obese adult females MATERIALS AND METHODS: This prospective study included 94 obese female (20-50 years old) as cases and 94 Non-obese of same age as controls for baseline comparisons. Obese female were assigned for low calorie diet (1200-1500 Kcal/day) in addition to a daily program of therapeutic exercise for six month. Parameters were measured, statistically analyzed and compared with control before and after study. RESULTS: baseline measurements showed significant differences between cases and control regarding BMI, TG, TC, LDL-C, TSH, T3 and T4. After six months of low calorie diet and exercise there was a significant decrease in BMI, TC, TG and LDL-C in cases as compared to their levels before the study (Pâ¯≤â¯0.05). TSH was significantly increased, while, T3 and T4 were significantly decreased in the cases as compared to their levels before the study. Statistically significant correlations were reported between different parameters of the study. CONCLUSIONS: Low calorie diet and moderate intensity therapeutic exercise significantly improved the deteriorated health indicators in the cases which justifies the necessity for introducing such low calorie diet coupled with moderate exercise.
