Infectious Endophthalmitis After Intravitreal Injection of Triamcinolone Acetonide

ABSTRACT

PURPOSE: We report 2 cases of infectious endophthalmitis after intravireal triamcinolone acetonide injection which was successfully treated with early vitrectomy. METHODS: A 56 year old male patient with chronic cystoid macular edema of right eye and an 84 year old female patient with diabetic macular edema of right eye (pseudophakic) eye were treated with intravireal triamcinolone acetonide injection. Four days after the injection, both the patients complained of decreased visual acuity that had been developed 1 and 2 days prior respectively. Visual acuity was hand motion, inflammatory cells, flare, fibrins and hypopyon were found in the anterior chamber. Fundus was not visible due to vitreous opacity. RESULTS: The two patients were presumed to have infectious endophthalmitis. Anterior chamber irrigation, vitrectomy, intravitreal antibiotics injection, and vitreous culture were performed. Coagulase negative staphylococcus was detected from vitreous culture, Within 1 week of the follow-up procedures, the anterior chamber and vitreous inflammation were improved and visual acuity recovered to the level attained before intravireal triamcinolone acetonide injection. CONCLUSIONS: If after intravireal triamcinolone acetonide injection, there is severely decreased visual acuity, inflammation of the anterior chamber and vitreous, flare and fibrin are detected, infectious endophthalmitis must be suspected. If diagnosed early and treated with vitrectomy, a favorable visual prognosis is expected.