To report prevalence and visual outcome in acute endophthalmitis after intravitreal injection.

This single center retrospective non comparative case series study included all patients who underwent intravitreal injection and developed acute endophthalmitis in Khatam Eye hospital affiliated to Mashhad University of Medical Sciences from March 2005 to March 2015. Demographic data and ocular findings of 12 patients with endophthalmitis were reviewed.

There was 12 cases of acute endophthalmitis among a total of 23618 injections. The incidence of acute endophthalmitis was 0.053% (1 per 1883 injections). Bevacizumab was the most common drug used (76.5%). Other drugs were triamcinolone (3.4%), Bevacizumab+ triamcinolone (3.4%) and Bevacizumab+ dexamethasone (16.7%). The median age was 61.83 years (range, 51-75 years). The median number of days from injection to presentation was 1.82(1-9) days. The most common symptom was pain (58.3%). Three cases out of 12(25%) were culture-positive. Two cases caused by Staphylococcus epidermidis and other case by Staphylococcus aureus. The initial treatment in all patients was intravitreal injection of antibiotics. Vitrectomy was performed in 4 (33.3%) cases. Comparison between primary visual acuity and final visual acuity was significant (p = 0.011).

The rate of endophthalmitis was very low (0.053%) but visually devastating. The use of intravitreal injection has greatly increased, therefore prevention, immediately diagnosis and treatment of endophthalmitis are important.