Real-world incidence of endophthalmitis after intravitreal anti-VEGF injection: Common Data Model in ophthalmology

Mun, Yongseok; You, Seng Chan; Lee, Da Yun; Kim, Seok; Chung, Yoo-Ri; Lee, Kihwang; Song, Ji Hun; Park, Young Gun; Park, Young Hoon; Roh, Young-Jung; Woo, Se Joon; Park, Kyu Hyung; Park, Rae Woong; Yoo, Sooyoung; Chang, Dong Jin; Park, Sang Jun

doi:2021.0.0.e2021097

Original article

Epidemiology and Health 2021;e2021097.
DOI: https://doi.org/10.4178/epih.e2021097 [Accepted] Published online Nov 9, 2021.

Real-world incidence of endophthalmitis after intravitreal anti-VEGF injection: Common Data Model in ophthalmology

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
²Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
³Healthcare ICT Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, Korea
⁴Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
⁵Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
⁶Department of Ophthalmology and Visual Science, Yeouido St. Mary’s Hospital, College of Medicine, Seoul, Korea

Correspondence Sang Jun Park ,Tel: +82-31-787-7382, Email: sangjunpark@snu.ac.kr

Received: Aug 19, 2021 Accepted after revision: Nov 9, 2021

Abstract

Objectives:
To evaluate the real-world incidence of endophthalmitis after intravitreal anti-vascular endothelial growth factor (VEGF) injection through the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM).
Method:
Patients with endophthalmitis developing within 6 weeks after intravitreal anti-VEGF injections were identified in three large OMOP CDM databases.
Results:
We identified 23,490 patients who received 128,123 intravitreal anti-VEGF injections. The incidence rates of endophthalmitis were 15.75 per 10,000 patients and 2.97 per 10,000 injections. The incidence rates of endophthalmitis for bevacizumab, ranibizumab, and aflibercept (per 10,000 injections) were 3.65, 1.39, and 0.76, respectively. The annual incidences have been below 5.00 per 10,000 injections since 2011 although the number of intravitreal anti-VEGF injections have been increasing. Bevacizumab presented a higher incidence rate for endophthalmitis than ranibizumab and aflibercept (incidence rate ratio = 3.17; P value = 0.021).
Conclusions:
The incidence of endophthalmitis after intravitreal anti-VEGF injections have been stabilized since 2011 despite the explosive increase of anti-VEGF injections. The off-label use of bevacizumab raised more endophthalmitis significantly. The OMOP CDM, which includes off-label uses, laboratory data, and scalable standardized database, could provide a novel strategy to reveal real-world evidence especially in ophthalmic fields.

Keywords: Anti-VEGF; Endophthalmitis; CDM; Real-world; Evidence