Endophthalmitis after intravitreal injections during the COVID-19 pandemic with implementation of universal masking.

Naguib, Mina M; Ghauri, Sophia; Mukhopadhyay, Anirudh; Schefler, Amy C

PURPOSE To evaluate the rates of post-intravitreal injection related endophthalmitis during the COVID-19 pandemic with institution of both physician and patient face masking. METHODS All eyes receiving intravitreal injections of any kind from a single large tertiary retina practice in Houston, TX, USA before (August 2017-March 22, 2020) and after (March 23, 2020-Sept 2020) COVID-19 pandemic universal masking protocols. The total number of injections and cases of acute injection-related endophthalmitis were determined from billing records and subsequent retrospective chart review. The primary outcome was the rate of endophthalmitis after intravitreal injection. Secondary outcomes included visual acuity, time until initial presentation, patient age, and differences in overall number of injections performed monthly pre- and post-COVID 19. RESULTS A total of 134, 097 intravitreal injections were performed during the study period (111,679 pre-COVID-19 and 22,418 post-COVID-19 masking protocols). A total of 41 cases of acute endophthalmitis occurred in the pre-COVID group (0.04%, 1 in 2500) and 7 cases in post COVID group (0.03%, 1 in 3333) p = 0.85. CONCLUSION In this single center, retrospective study, the implementation of universal patient and physician masking as practiced during the COVID-19 pandemic did not significantly affect the rate of post intravitreal injection endophthalmitis.