J Korean Ophthalmol Soc > Volume 49(3); 2008 > Article
Journal of the Korean Ophthalmological Society 2008;49(3):464-470.
DOI: https://doi.org/10.3341/jkos.2008.49.3.464    Published online March 31, 2008.
Clinical Manifestations of Presumed Sterile Endophthalmitis After Intravitreal Triamcinolone Injection.
Wool Suh, Soo Young Lee, Jeong Hee Lee
Department of Ophthalmology, College of Medicine, Ewha Womans University, Seoul, Korea. leejhoph@ewha.ac.kr
유리체내 트리암시놀론 주사후 발생한 무균성 안내염에 대한 고찰
서 울·이수영·이정희
Department of Ophthalmology, College of Medicine, Ewha Womans University, Seoul, Korea
Correspondence:  Wool Suh, M.D.
Abstract
PURPOSE
To evaluate the distinguishing characteristics that may assist in the clinical diagnosis of sterile endophthalmitis from intravitreal triamcinolone injection. METHODS: From January 2005 to June 2006, the medical records of 163 eyes that received intravitreal triamcinolone injection were reviewed. In 5 eyes of 5 patients who complained of decreasing vision and mild ocular pain within three days after injection, slit lamp bimicroscopy revealed hypopyon, anterior chamber reaction, and vitritis. We analyzed clinical pictures retrospectively. RESULTS: Intravitreal triamcinolone injections were performed for diabetic macular edema in 4 patients and for panuveitis in 1 patient with Behcet's disease. Pseudophakia was found in all five eyes. Inflammations in three eyes resolved with topical and oral antibiotics within 13 days, and the other two patients were treated with a vitreous culture and intravitreal antibiotic injection. However, vitreous tap showed no evidence of endophthalmitis, and inflammation resolved within the same period. CONCLUSIONS: Presumed sterile endophthalmitis presents within 3 days after intravitreal triamcinolone injection and may be accompanied by decreased vision and ocular discomfort, although it is characterized by no distinct ocular pain. The symptoms and ocular inflammation resolved quickly within 13 days with a favorable visual outcome. Inflammations in three eyes resolved without surgical intervention, so it may be necessary to closely observe clinical manifestations before assuming that the eye is suffering from infectious endophthalmitis.
Key Words: Hypopyon;Intravitreal injection;Triamcinolone acetonide;Sterile endophthalmitis


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