Retina-Vitreous
2013 , Vol 21 , Num 1
Acinetobacter Baumannii Endophthalmitis Following Intravitreal Ranibizumab Injection
1M.D., Malatya Universal Hospital, Eye Clinic, Malatya/TURKEY2M.D. Associate Professor, İnonu University Faculty of Medicine, Department of Ophthalmology, Malatya/TURKEY
3M.D. Professor, İnonu University Faculty of Medicine, Department of Ophthalmology, Malatya/TURKEY We aimed to report a case who developed Acitenobacter baumannii endophthalmitis after intravitreal Ranibizumab (Lucentis®) injection. A 79-year-old male patient was admitted with vision loss in both eyes. Fluorescein angiography showed dry type age-related macular degeneration (ARMD) in the right eye and subretinal hemorrhage secondary to subfoveal classic type choroidal neovascular membrane in the left eye. Intravitreal injections of 3-dose Ranibizumab (Lucentis®) at monthly intervals were planned for the left eye of the patient. After the injection of the third dose of Ranibizumab, on the third day, the patient returned to the clinic with a complaint of excruciating ocular pain, red eye and vision loss in the left eye. The visual acuity of the patient was at the level of light perception. A slit lamp examination and B-mode ultrasonography revealed endophthalmitis. The patient was promptly hospitalised and medical treatment was started. After the sampling of vitreous from the left eye, vancomycin and ceftazidime were intravitreally administered. Systemic cefazolin and gentamicin, topical fortified vancomycin and ceftazidime, and topical moxifloxacin along with topical cycloplegic drops were started. Pars plana vitrectomy could not be performed due to corneal opacification. Four days after the initialisation of the therapy, the culture of the vitreous sample yielded Acinetobacter baumannii. In the following days, no regression in the clinical picture was determined and the level of the visual acuity worsened to light perception loss.
Acute Acinetobacter baumannii endophthalmitis following intravitreal Ranibizumab injection occurs rapidly and can result in severe loss of vision. Although endophthalmitis is rare, ophthalmologists should be alert to the possibility of patients having endophthalmitis caused by A. baumannii.
Keywords : Acinetobacter baumannii, endophthalmitis, Intravitreal injection