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[Endophthalmitis as a complication of intravitreal anti-VEGF therapy in patients with exudative age-related macular degeneration and degenerative myopia].

Anti-vascular endothelial growth factor agents, injected intravitreally, became a standard therapy for choroidal neovascularization in a course of wet age-related macular degeneration and degenerative myopia. Endophthalmitis is a very rare but the most serious complication associated with this procedure. The purpose of this paper is to present three patients with endophthalmitis following intravitreal injections of anti-VEGF agents. In the analysed material, the authors confirmed endophthalmitis in 2 of 4176 patients with exudative age-related macular degeneration and choroidal neovascularization associated with degenerative myopia (0.048%). The third reported case is a patient with endophthalmitis following the injection of bevacizumab performed in another center. The time interval between the injection and the onset of endophthalmitis was 2-5 days. In two patients who underwent pars plana vitrectomy--one patient regained best corrected visual acuity, while another showed no improvement and developed eye atrophy. In one case the microbiological examination showed a growth of Staphylococcus epidermidis, while in another a negative culture result was present. Endopthalmitis is a rare complication following the intravitreal injections of anti-VEGF agents. The proper selection of therapy depends on presenting best corrected visual acuity and severity of intraocular inflammation. The time of commencing treatment is a crucial prognostic factor, however, our observations showed that prompt and repeated surgical procedures cannot prevent irreversible vision loss in all cases.