Abstract
BACKGROUND/AIMS: To evaluate the association between blood glucose levels and the development of endophthalmitis in patients receiving anti-vascular endothelial growth factor (VEGF) injections. METHODS: Retrospective analysis of electronic medical records of patients who received anti-VEGF injections at four centres within a single ophthalmic institution. Pre-injection, random, fasting, and post-prandial blood glucose levels were analysed with respect to the development of endophthalmitis. The association between blood glucose levels, and the presence and duration of diabetes mellitus (DM), and the development of post-injection endophthalmitis was determined. RESULTS: This study included 60,707 injections administered to 25,751 patients, 48.73% of whom had DM. Sixteen patients developed post-injection endophthalmitis; incidence rate was 6 per 10,000 patients (0.06%) and 2 per 10,000 injections (0.03%). A higher proportion of patients with endophthalmitis had DM (68.75%), compared to those without endophthalmitis (48.72%). The presence of diabetes had a significant association with post-injection endophthalmitis (OR 5.05, 95% CI 1.82-16.27, P-0.00). Regarding duration of diabetes, there was no statistically significant difference between patients with and without endophthalmitis (OR 3.33, P = 0.281). Compared to patients without endophthalmitis, those with endophthalmitis had similar random blood glucose levels (150.89 ± 63.75 mg/dL vs. 141 ± 64 mg/dL), similar fasting blood glucose levels (135.86 ± 32.73 mg/dL vs. 132 ± 53 mg/dL), and higher post-prandial levels (208.2 ± 69.12 mg/dL vs. 188 ± 56 mg/dL), but it was not statistically significant. CONCLUSION: We found a significant association between presence of diabetes and post-injection endophthalmitis. Immediate pre-injection blood glucose levels were not associated with post-injection endophthalmitis but the duration of diabetes was longer in patients developing endophthalmitis.