{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:02:17Z","timestamp":1789776137834,"version":"4.0.1"},"reference-count":12,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Ocular Pharmacology and Therapeutics"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:p>Crystalline opacities appearing after intravitreal antibiotic injections can closely mimic worsening endophthalmitis, potentially prompting unnecessary surgical or pharmacologic interventions. This underrecognized phenomenon, most commonly seen after sequential intravitreal administration of vancomycin and ceftazidime, results from physicochemical incompatibility leading to intraocular precipitation. Despite their alarming appearance, these crystalline deposits are benign, self-limited, and retain antimicrobial activity. Review of the few published human cases reveals favorable outcomes with conservative management once infection is excluded. Recognizing this entity is crucial to avoid misdiagnosis, overtreatment, and medicolegal implications. Awareness of preventive measures\u2014such as using separate syringes, staggered injections, and warmed solutions\u2014can further minimize risk. Ultimately, differentiating true infectious progression from sterile drug precipitation preserves both vision and clinical judgment.<\/jats:p>","DOI":"10.1177\/10807683261467743","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T08:14:46Z","timestamp":1783066486000},"page":"526-529","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Not All that Clouds Is Infection: Intravitreal Precipitation after Sequential Antibiotic Injection"],"prefix":"10.1177","volume":"42","author":[{"given":"Yara","family":"Abukhaled","sequence":"first","affiliation":[{"name":"The University of Tennessee Health and Science Center, Memphis, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameen","family":"Alkhateeb","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-2188","authenticated-orcid":false,"given":"Hashem","family":"Abu Serhan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12118"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00728-08"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1995.01100120009001"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2023.101218"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.84.1.117a"},{"issue":"4","key":"e_1_3_2_7_1","first-page":"1182","article-title":"An in vitro study of ceftazidime and vancomycin concentrations in various fluid media: Implications for use in treating endophthalmitis","volume":"43","author":"Kwok AK","year":"2002","unstructured":"6.Kwok AK, , Hui M, , Pang CP, et al. An in vitro study of ceftazidime and vancomycin concentrations in various fluid media: Implications for use in treating endophthalmitis. Invest Ophthalmol Vis Sci 2002;43(4):1182\u20131188.","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2018.0080"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfo.2020.04.029"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0b013e318154ba07"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2021.04.010"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2022.2152"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/jop.2012.0064"}],"container-title":["Journal of Ocular Pharmacology and Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10807683261467743","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10807683261467743","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10807683261467743","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:18:08Z","timestamp":1789773488000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10807683261467743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":12,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,11,1]]}},"alternative-id":["10.1177\/10807683261467743"],"URL":"https:\/\/doi.org\/10.1177\/10807683261467743","relation":{},"ISSN":["1080-7683","1557-7732"],"issn-type":[{"value":"1080-7683","type":"print"},{"value":"1557-7732","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}