Retina News

DRCR.net: Exclusion of Topical Antibiotics Not Associated with Higher Risk of Endophthalmitis

Watch it Now

Exclusion of topical antibiotics during intravitreal injections for diabetic eye disease was not associated with a higher risk of endophthalmitis, according to an update from the Diabetic Retinopathy Clinical Research Network (DRCR.net) published in JAMA Opthalmology.1 The authors said that continued use of povidone-iodine was within DRCR.net protocol and that the DRCR.net would consider elimination of topical antibiotic use as part of its intravitreal injection protocol.

Researchers reviewed nearly 29,000 intravitreal injections administered in more than 3100 eyes across eight DRCR.net clinical trials conducted from 2006 to 2015. In cases involving the use of povidone-iodine, nine cases of endophthalmitis occurred: six cases in eyes receiving topical antibiotics and three cases in eyes not receiving topical antibiotics (P = .17).

Researchers also collected data on cases in which povidone-iodine was not used, a violation of DRCR.net injection protocol. Thirteen injections in three eyes of two participants were administered without povidone-iodine; both participants developed endophthalmitis.

1. Bhavsar AR, Glassman, Stockdale CR, Jampol LM; the Diabetic Retinopathy Clinical Research Network. Elimination of topical antibiotics for intravitreous injections and the importance of using povidone-iodine: update from the Diabetic Retinopathy Clinical Research Network [published online ahead of print August 11, 2016]. JAMA Ophthalmol.

Global Estimate Forecasts Increase in Blindness Due to DR

The number of patients with visual impairment or blindness due to diabetic retinopathy (DR) is rising, according to a study published in Diabetes Care.1 The risk of visual impairment or blindness due to DR has increased proportionally over time, according to the study authors.

Researchers performed a metaanalysis of published population studies from 1990 to 2012, identifying rates of moderate and severe vision impairment (visual acuity < 6/18 to ≥ 3/60) and blindness (visual acuity < 3/60) due to DR.

The researchers identified more than 32 million blind people and more than 190 people visually impaired for all reasons; nearly 1 million patients were blind, and more than 3.5 million patients were visually impaired due to DR. DR accounted for 2.6% of all blindness in 2010, up from 2.1% in 1990. DR accounted for 1.9% of all visual impairment, up from 1.3% in 1990.

Rates of blindness or visual impairment due to DR were lowest in East Asia, Southeast Asia, and Oceania, and highest in North America, Western Europe, and Australasia. Researchers tied low rates of DR to regions with younger populations and high rates of DR to high-income regions with aging populations. n

1. Leasher JL, Rourne RRA, Flaxman SR, et al; the Vision Loss Expert Group of the Global Burden of Disease Study. Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 1990 to 2010. Diabetes Care. 2016;39(9):1643-1649.