Download fulltext
HTML
1.
Karimi S, Nikkhah H, Mohammadzadeh A, Ramezani A, Ansari I, Nouri H, Abtahi S-H. Intravitreal Injections and Face Masks: Endophthalmitis Risk Before and During the COVID-19 Pandemic. JOVR [Internet]. 2023Jul.23 [cited 2024May15];18(3):283–288. Available from: https://knepublishing.com/index.php/JOVR/article/view/13776
https://doi.org/10.18502/jovr.v18i3.13776
statistics
- 499 Abstract Views
- 389 PDF Views
- 0 HTML Views
authors
-
Saeed Karimi
Saeed Karimi
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Homayoun Nikkhah
Homayoun Nikkhah
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Amir Mohammadzadeh
Amir Mohammadzadeh
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Alireza Ramezani
Alireza Ramezani
Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Iman Ansari
Iman Ansari
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Hosein Nouri
Hosein Nouri
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Seyed-Hossein Abtahi
Seyed-Hossein Abtahi
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Published Date
- Jul 23, 2023
Intravitreal Injections and Face Masks: Endophthalmitis Risk Before and During the COVID-19 Pandemic
Abstract
Purpose: To assess the added risk of acute endophthalmitis after intravitreal injections associated with the widespread use of face masks during the COVID-19 pandemic.
Methods: In this retrospective, single-center study, records of patients with acute endophthalmitis following intravitreal bevacizumab (IVB) injections during the pre-COVID era—that is, March 1st , 2013 to October 31st, 2019 —and the COVID-19 era—that is, March 1st, 2020 to April 1st, 2021 —were reviewed and compared.
Results: A total of 28,085 IVB injections were performed during the pre-COVID era; nine eyes of nine patients developed acute post-IVB endophthalmitis in this era, giving an overall incidence of 0.032% (3.2 in 10,000 injections). In the COVID era, 10,717 IVB injections were performed; four eyes of four patients developed acute post-IVB endophthalmitis in this era, giving an overall incidence of 0.037% (3.7 in 10,000 injections). The incidences of post-IVB endophthalmitis during these two eras were not statistically significantly different (P = 0.779).
Conclusion: Face masking protocols seem unlikely to impose any additional risk of post-IVB endophthalmitis.
Keywords:
COVID-19; Endophthalmitis; Face Mask; Intravitreal Injection; Infection
References
1. Maloney MH, Payne SR, Herrin J, Sangaralingham LR, Shah ND, Barkmeier AJ. Risk of systemic adverse events after intravitreal bevacizumab, ranibizumab, and aflibercept in routine clinical practice. Ophthalmology 2021;128:417–424.
2. Soliman MK, Gini G, Kuhn F, Iros M, Parolini B, Ozdek S, et al. International practice patterns for the management of acute postsurgical and postintravitreal injection endophthalmitis: European Vitreo-Retinal Society endophthalmitis study report 1. Ophthalmol Retina 2019;3:461–467.
3. Lyall DA, Tey A, Foot B, Roxburgh ST, Virdi M, Robertson C, et al. Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom: Incidence, features, risk factors, and outcomes. Eye 2012;26:1517–1526.
4. Fintak DR, Shah GK, Blinder KJ, Regillo CD, Pollack J, Heier JS, et al. Incidence of endophthalmitis related to intravitreal injection of bevacizumab and ranibizumab. Retina 2008;28:1395–1399.
5. Klompas M, Morris CA, Sinclair J, Pearson M, Shenoy ES. Universal masking in hospitals in the Covid-19 era. N Engl J Med 2020;382:e63.
6. Al-Sayah MH. Chemical disinfectants of COVID-19: An overview. J Water Health 2020;18:843–848.
7. Rabenau HF, Kampf G, Cinatl J, Doerr HW. Efficacy of various disinfectants against SARS coronavirus. J Hosp Infect 2005;61:107–111.
8. Advani SD, Smith BA, Lewis SS, Anderson DJ, Sexton DJ. Universal masking in hospitals in the COVID-19 era: Is it time to consider shielding? Infect Control Hosp Epidemiol 2020;41:1066–1067.
9. Wang X, Ferro EG, Zhou G, Hashimoto D, Bhatt DL. Association between universal masking in a health care system and SARS-CoV-2 positivity among health care workers. JAMA 2020;324:703–704.
10. Wen JC, McCannel CA, Mochon AB, Garner OB. Bacterial dispersal associated with speech in the setting of intravitreous injections. Arch Ophthalmol 2011;129:1551– 1554.
11. Patel SN, Hsu J, Sivalingam MD, Chiang A, Kaiser RS, Mehta S, et al. The impact of physician face mask use on endophthalmitis after intravitreal anti-vascular endothelial growth factor injections. Am J Ophthalmol 2021;222:194– 201.
12. Storey P, Dollin M, Pitcher J, Reddy S, Vojtko J, Vander J, et al. The role of topical antibiotic prophylaxis to prevent endophthalmitis after intravitreal injection. Ophthalmology 2014;121:283–289.
13. Xu K, Chin EK, Bennett SR, Williams DF, Ryan EH, Dev S, et al. Endophthalmitis after intravitreal injection of vascular endothelial growth factor inhibitors: Management and visual outcomes. Ophthalmology 2018;125:1279–1286.
14. Rayess N, Rahimy E, Storey P, Shah CP, Wolfe JD, Chen E, et al. Postinjection endophthalmitis rates and characteristics following intravitreal bevacizumab, ranibizumab, and aflibercept. Am J Ophthalmol 2016;165:88–93.
15. Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999;26:259–265.
16. Patel SN, Tang PH, Storey PP, Wolfe JD, Fein J, Shah SP, et al. The influence of universal face mask use on endophthalmitis risk after intravitreal anti-vascular endothelial growth factor injections. Ophthalmology 2021;128:1620–1626.
17. Doshi RR, Leng T, Fung AE. Reducing oral flora contamination of intravitreal injections with face mask or silence. Retina 2012;32:473–476.
18. Hadayer A, Zahavi A, Livny E, Gal-Or O, Gershoni A, Mimouni K, et al. Patients wearing face masks during intravitreal injections may be at a higher risk of endophthalmitis. Retina 2020;40:1651–1656.
19. Patel SN, Mahmoudzadeh R, Salabati M, Soares RR, Hinkle J, Hsu J, et al. Bacterial dispersion associated with various patient face mask designs during simulated intravitreal injections. Am J Ophthalmol 2021;223:178–183.
20. Schultheis WG, Sharpe JE, Zhang Q, Patel SN, Kuriyan AE, Chiang A, et al. Effect of taping face masks on quantitative particle counts near the eye: Implications for intravitreal injections in the covid-19 era. Am J Ophthalmol 2021;225:166–171.
21. Al-Khersan H, Kalavar MA, Tanenbaum R, Lazzarini TA, Patel NA, Yannuzzi NA, et al. Emergent ophthalmic surgical care at a tertiary referral center during the COVID-19 pandemic. Am J Ophthalmol 2021;222:368–372.
2. Soliman MK, Gini G, Kuhn F, Iros M, Parolini B, Ozdek S, et al. International practice patterns for the management of acute postsurgical and postintravitreal injection endophthalmitis: European Vitreo-Retinal Society endophthalmitis study report 1. Ophthalmol Retina 2019;3:461–467.
3. Lyall DA, Tey A, Foot B, Roxburgh ST, Virdi M, Robertson C, et al. Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom: Incidence, features, risk factors, and outcomes. Eye 2012;26:1517–1526.
4. Fintak DR, Shah GK, Blinder KJ, Regillo CD, Pollack J, Heier JS, et al. Incidence of endophthalmitis related to intravitreal injection of bevacizumab and ranibizumab. Retina 2008;28:1395–1399.
5. Klompas M, Morris CA, Sinclair J, Pearson M, Shenoy ES. Universal masking in hospitals in the Covid-19 era. N Engl J Med 2020;382:e63.
6. Al-Sayah MH. Chemical disinfectants of COVID-19: An overview. J Water Health 2020;18:843–848.
7. Rabenau HF, Kampf G, Cinatl J, Doerr HW. Efficacy of various disinfectants against SARS coronavirus. J Hosp Infect 2005;61:107–111.
8. Advani SD, Smith BA, Lewis SS, Anderson DJ, Sexton DJ. Universal masking in hospitals in the COVID-19 era: Is it time to consider shielding? Infect Control Hosp Epidemiol 2020;41:1066–1067.
9. Wang X, Ferro EG, Zhou G, Hashimoto D, Bhatt DL. Association between universal masking in a health care system and SARS-CoV-2 positivity among health care workers. JAMA 2020;324:703–704.
10. Wen JC, McCannel CA, Mochon AB, Garner OB. Bacterial dispersal associated with speech in the setting of intravitreous injections. Arch Ophthalmol 2011;129:1551– 1554.
11. Patel SN, Hsu J, Sivalingam MD, Chiang A, Kaiser RS, Mehta S, et al. The impact of physician face mask use on endophthalmitis after intravitreal anti-vascular endothelial growth factor injections. Am J Ophthalmol 2021;222:194– 201.
12. Storey P, Dollin M, Pitcher J, Reddy S, Vojtko J, Vander J, et al. The role of topical antibiotic prophylaxis to prevent endophthalmitis after intravitreal injection. Ophthalmology 2014;121:283–289.
13. Xu K, Chin EK, Bennett SR, Williams DF, Ryan EH, Dev S, et al. Endophthalmitis after intravitreal injection of vascular endothelial growth factor inhibitors: Management and visual outcomes. Ophthalmology 2018;125:1279–1286.
14. Rayess N, Rahimy E, Storey P, Shah CP, Wolfe JD, Chen E, et al. Postinjection endophthalmitis rates and characteristics following intravitreal bevacizumab, ranibizumab, and aflibercept. Am J Ophthalmol 2016;165:88–93.
15. Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999;26:259–265.
16. Patel SN, Tang PH, Storey PP, Wolfe JD, Fein J, Shah SP, et al. The influence of universal face mask use on endophthalmitis risk after intravitreal anti-vascular endothelial growth factor injections. Ophthalmology 2021;128:1620–1626.
17. Doshi RR, Leng T, Fung AE. Reducing oral flora contamination of intravitreal injections with face mask or silence. Retina 2012;32:473–476.
18. Hadayer A, Zahavi A, Livny E, Gal-Or O, Gershoni A, Mimouni K, et al. Patients wearing face masks during intravitreal injections may be at a higher risk of endophthalmitis. Retina 2020;40:1651–1656.
19. Patel SN, Mahmoudzadeh R, Salabati M, Soares RR, Hinkle J, Hsu J, et al. Bacterial dispersion associated with various patient face mask designs during simulated intravitreal injections. Am J Ophthalmol 2021;223:178–183.
20. Schultheis WG, Sharpe JE, Zhang Q, Patel SN, Kuriyan AE, Chiang A, et al. Effect of taping face masks on quantitative particle counts near the eye: Implications for intravitreal injections in the covid-19 era. Am J Ophthalmol 2021;225:166–171.
21. Al-Khersan H, Kalavar MA, Tanenbaum R, Lazzarini TA, Patel NA, Yannuzzi NA, et al. Emergent ophthalmic surgical care at a tertiary referral center during the COVID-19 pandemic. Am J Ophthalmol 2021;222:368–372.