6533b839fe1ef96bd12a60df

RESEARCH PRODUCT

How Big Data Informs Us About the Population Health Status : endophthalmitis after ophthalmologic procedures

subject

description

The use of Big Data, in the form of almost exhaustive French medico-administrative databases, has made it possible to address several issues without which this would not have been possible. First, to define the incidence of endophthalmitis after ophthalmologic procedures without bias on specific recruitment modalities of respondents (tertiary centers, questionnaires ...). Thus, local observations of a change in prevalence trends of causative procedures were confirmed at the national level. The reliable description of the incidence of endophthalmitis will then make it possible to identify critical situations of recrudescence of cases. The knowledge of the delay of occurrence after the procedure will allow to adapt the postoperative consultations or information taking in order to alert as soon as possible in case of signs suggestive of an endophthalmitis. Secondly, the existence of an excess risk in the case of IVT of non-prefilled anti-VEGF would not have been possible without the observation of a large number of endophthalmitis, which had not yet been done. The significant reduction of almost 50% in the risk of endophthalmitis with serious consequences with prefilled syringes is to the benefit of the patient. In addition, this study confirms the significant excess risk after corticosteroid injections, requiring particular vigilance and selection of patients treated. Similarly, a discussion with the patient at increased risk of infection requiring corticosteroid treatment could be initiated. Finally, in order to avoid the statistical uncertainty related to the multiple associations of antibiotic prophylaxis after IVT, a national cohort over 10 years, studying more than 5 million IVTs, was necessary. The results show that antibiotic prophylaxis does not reduce the risk of endophthalmitis after IVT and would even increase the risk of endophthalmitis if an antibiotic-corticoid combination is prescribed, which should be avoided.