Difference between the incidence of acute endophthalmitis after intravitreal injection regarding the use of face masks in the context of Covid-19 pandemic

Abstract

Purpose: The purpose was to compare the incidence of acute endophthalmitis after intravitreal injection (IVI) between the pre-COVID period and the COVID period to understand if the use of face mask in patients is relevant for this incidence. Methods: This is a single-center retrospective cross-sectional study in a tertiary university hospital. The patients included in this study were diagnosed with infectious endophthalmitis following an IVI of anti-vascular endothelial growth factor (anti-VEGF) or corticosteroids, during the pre-COVID period (February 2018 until February 2020) or the COVID period (March 2020 until March 2022). Patients with the diagnosis of endophthalmitis were found from electronic medical records using the codes of International Classification of Diseases. We collected demographics and clinical information about these patients. We assessed the total number of IVI performed in our hospital during the study period. Statistical analysis was performed using IBM SPSS Statistics 27. Results: Between February 2018 and March 2022, 47323 IVI were performed and 67 patients diagnosed with infectious endophthalmitis were diagnosed at our ophthalmology department. From these 67 cases, 17 were endophthalmitis after a previous IVI in the study hospital, which corresponds to an incidence of 0,0359%. In the pre-COVID period, 8 cases of endophthalmitis were diagnosed and 20011 IVI were performed, which corresponds to an incidence of 0,0400%. During the Covid-19 pandemic period, 9 endophthalmitis were diagnosed after 27307 IVI, which corresponds to an incidence of 0,0330%. There were no statistical differences in the incidence of infectious endophthalmitis between the 2 groups of patients (p=0,691). Conclusion: The incidence, clinical presentation and prognosis of infectious endophthalmitis after intravitreal injections is not statistically different between the pre-COVID period and after the beginning of Covid-19 pandemic. The generalized use of face masks by the population does not seem to interfere with the risk of endophthalmitis.