Haemorrhagic occlusive retinal vasculitis caused by Intravitreal Vancomycin

Muid, Javeria; Awan, Muhammad Amer

doi:10.5455/jpma.46528

Cited by 4 publications

(3 citation statements)

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“…Для лечения васкулитов HORV или вызванных применением бролуцизумаба авторы публикаций применяли в дополнение к системной терапии ГКС интравитреальные/субтеноновые инъекции ГКС или интравитреальное введение имплантата с ГКС [45]. В редких случаях при быстром развитии окклюзирующих васкулитов, вызванных различными веществами, для снижения уровня концентрации иммунных комплексов в витреальной полости описано применение витрэктомии [15].…”

Section: Fa Of Patient With Retinovasculitis O N T H E R E T I N a L Peripheryunclassified

“…При васкулитах сетчатки могут поражаться как артерии, так и вены, а также оба сосудистых русла одновременно, что является причиной разнообразия клинической картины. Помимо идиопатических и инфекционных васкулитов в последнее время многие авторы описывают окклюзирующие васкулиты (haemorrhagic occlusive retinal vasculitis, HORV) после хирургических вмешательств, в частности после хирургии катаракты и/или после интравитреальных/интракамерных инъекций ванкомицина [14][15][16]. Большинство авторов связывают появление данного заболевания именно с токсическим действием ванкомицина, однако есть мнение, что развитие HORV связано прежде всего с аутоиммунными процессами, а именно с реакцией гиперчувствительности III типа [17].…”

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Modern concept of a new group of retinal vasculitis

Лоскутов

Коврижкина

Andryuhina

2022

Rossijskij oftalʹmologičeskij žurnal

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Retinal vasculitis is a rare condition that occurs both in systemic severe diseases and as an adverse event of intraocular drug injections. With the emergence of new anti-VEGF drugs, a number of international authors report on the occurrence of retinal occlusive vasculitis, which led to a decrease in visual acuity. The review presents possible pathogeneses of this condition, approaches to its diagnosis and an algorithm for managing the patients with occlusive vasculitis.

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Section: Fa Of Patient With Retinovasculitis O N T H E R E T I N a L Peripheryunclassified

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Modern concept of a new group of retinal vasculitis

Лоскутов

Коврижкина

Andryuhina

2022

Rossijskij oftalʹmologičeskij žurnal

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“…47 There have been no reports of vancomycin-resistant organisms in post-IVI endophthalmitis, although there have been a few cases in endophthalmitis of other etiologies. 22 Although hemorrhagic occlusive retinal vasculitis has been reported after IVI of vancomycin, 48,49 the rarity of this complication and the absence of a similarly efficacious alternative in the context of a blinding condition such as endophthalmitis justify its continued use. Since the EVS, ceftazidime 2.25 mg/0.1 mL has largely replaced amikacin for gram-negative coverage.…”

Section: Spectrum Of Bacterial Isolates and Selection Of Antibioticsmentioning

confidence: 99%

Clinical Practice Update: Management of Infectious Endophthalmitis After Intravitreal Anti-VEGF Injection

Merani

Johnson

McCannel

et al. 2022

Journal of VitreoRetinal Diseases

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Although infectious endophthalmitis after intravitreal antivascular endothelial growth factor injections is rare, it is the most feared and potentially devastating complication of this procedure. There is no high-level evidence to provide definitive guidance on the management of endophthalmitis occurring after intravitreal injection (IVI). This clinical practice update reviews the published literature regarding post-IVI endophthalmitis and highlights areas in which further research is needed to better guide its management.

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Modified-dropless protocol (nil intraocular) for micro-incision vitrectomy surgery (MIVS): a retrospective pilot study

2023

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Background Perioperative infection and inflammation prophylaxis after ocular surgery has evolved over the years along with improvements in surgical equipment and a growing interest in alternatives to the standard topical eye drops. The purpose of this study is to evaluate the outcomes of a novel, modified-dropless protocol for 23-gauge (23-G), 25-gauge (25-G) and 27-gauge (27-G) micro-incision vitrectomy surgery (MIVS) that omits any intraocular injections of antibiotics or steroids. Methods This Institutional Review Board-approved, single-surgeon retrospective study reviewed MIVS post-surgical outcomes in patients who received a modified-dropless protocol from February 2020 to March 2021. A total of 158 charts were reviewed, of which 150 eyes met the eligibility criteria. After each case, patients were administered a 0.5 cc subconjunctival injection of a 1:1 Cefazolin (50 mg/cc):Dexamethasone (10 mg/cc) in the inferior fornix and 0.5 cc of posterior Sub-Tenon’s Kenalog (STK). No intravitreal injections were administered, and no pre- or postoperative antibiotic or steroid eye drops were prescribed. For patients allergic to penicillin, separate subconjunctival injections of 0.25 cc each of Vancomycin (10 mg/cc) and Dexamethasone (10 mg/cc) were administered. The primary safety parameter was postoperative cases of endophthalmitis. Secondary endpoints consisted of Best-Corrected Distance Visual Acuity (BCVA), intraocular pressure (IOP), and postoperative complications (retinal detachments, inflammation, need for additional surgery) within three months of surgery. Statistical analysis was performed using chi-square (χ²) tests for categorical values, and a Student’s t-test to compare continuous outcomes. Results The majority of surgeries (96%) were performed with the 27G MIVS platform. There were no cases of postoperative endophthalmitis. Mean logMAR BCVA improved from 0.71 (± 0.67) to 0.61 (± 0.60) post-operatively (p = 0.02). Excluding patients who had silicone oil tamponade, postoperative BCVA improved from 0.67 (± 0.66) to 0.54 (± 0.55) (p = 0.003). Mean IOP increased from 14.6 (± 3.8) to 15.3 (± 4.1) (p = 0.05). Ten patients required further medication therapy for an increase in IOP, one had inflammatory signs, and 14 required a second surgical intervention mostly due to recurrences of initial surgical indication. Conclusion A modified-dropless postoperative protocol involving subconjunctival and posterior sub-Tenon’s injections only may be a safe and convenient alternative to topical eye drops for patients undergoing MIVS, but additional and larger studies are needed.

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Haemorrhagic occlusive retinal vasculitis caused by Intravitreal Vancomycin

Cited by 4 publications

References 0 publications

Modern concept of a new group of retinal vasculitis

Modern concept of a new group of retinal vasculitis

Clinical Practice Update: Management of Infectious Endophthalmitis After Intravitreal Anti-VEGF Injection

Modified-dropless protocol (nil intraocular) for micro-incision vitrectomy surgery (MIVS): a retrospective pilot study

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