PURPOSE: To describe two cases of sterile endophthalmitis following intravitreal injection of preservative-free triamcinolone acetonide. METHODS: Chart review. RESULTS: Two patients with histories of sterile inflammatory reaction to intravitreal Kenalog (triamcinolone acetonide) subsequently were treated with intravitreal injections of preservative-free triamcinolone. Both patients presented 2 to 3 days after injection with significant anterior chamber cell reaction without pain or inflammation-related conjunctival injection. The intraocular inflammation of both patients resolved completely using only topical steroids and antibiotics. CONCLUSIONS: An inflammatory reaction to the vehicle has been the leading hypothesis for the etiology of the sterile inflammatory response following intravitreal Kenalog injections. The use of preservative-free triamcinolone is intended to eliminate this potential source of toxicity. These cases demonstrate that noninfectious endophthalmitis can develop even with preservative-free triamcinolone.
PURPOSE: To describe two cases of sterile endophthalmitis following intravitreal injection of preservative-free triamcinolone acetonide. METHODS: Chart review. RESULTS: Two patients with histories of sterile inflammatory reaction to intravitreal Kenalog (triamcinolone acetonide) subsequently were treated with intravitreal injections of preservative-free triamcinolone. Both patients presented 2 to 3 days after injection with significant anterior chamber cell reaction without pain or inflammation-related conjunctival injection. The intraocular inflammation of both patients resolved completely using only topical steroids and antibiotics. CONCLUSIONS: An inflammatory reaction to the vehicle has been the leading hypothesis for the etiology of the sterile inflammatory response following intravitreal Kenalog injections. The use of preservative-free triamcinolone is intended to eliminate this potential source of toxicity. These cases demonstrate that noninfectious endophthalmitis can develop even with preservative-free triamcinolone.
Authors: Ahmed Mahjoub; Nadia Ben Abdesslem; Atf Ben Abderrazek; Nesrine Zaafrane; Anis Mahjoub; Hichem Aoun; Ahmed Jabri; Fethi Krifa; Mohamed Ghorbel; Hachemi Mahjoub Journal: Ann Med Surg (Lond) Date: 2022-03-28