{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:32:24Z","timestamp":1786649544616,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6]]},"abstract":"\n Purpose:<\/jats:title>\n Millipore filters are routinely used in vitreous surgeries for loading intraocular gas. This study purports to establish feasibility of in-line Millipore filter as a filtration barrier and rationalize their use during intravitreal antivascular endothelial growth factor (antiVEGF) injection to reduce the risk of endophthalmitis.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Proof-of-concept in-vitro study.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n At the Ocular Microbiology section of a tertiary care eye center in North India, bacterial broths of various microorganisms (\n Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa<\/jats:italic>\n ,\n Escherichia coli<\/jats:italic>\n ,\n Corynebacterium species, Streptococcus species<\/jats:italic>\n , and a mixture of\n Staphylococcus aureus<\/jats:italic>\n and\n Pseudomonas aeruginosa<\/jats:italic>\n ) of different concentrations (McFarland 0.5 and McFarland 1) were inoculated onto blood, chocolate, and\/or MacConkey agar with (Group 1) or without (Group 2) in-line sterile Millipore filter of 0.22-micron pore size (Set GS Mini filter, ARCEOLE, France). The filter was attached to a one-ml syringe with bacterial broth solution at one end and a 30-gauge needle at the other. Culture plates were incubated and observed daily for colony formation with photographic documentation for up to 5 days.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Bacterial broths could be injected across the filter with little resistance. None of the culture media showed growth when filters were used, compared with growth in all culture plates when inoculation of broth was done without the filter. The fluid loss in the filter (dead space volume) ranged from 0.12 to 0.17 ml.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Millipore filter act as an effective filtration barrier and could enhance the safety of intravitreal antiVEGF injection by reducing the risk of endophthalmitis. Further microbiological and toxicology studies are essential before their integration into clinical practice.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_3071_24","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T11:03:17Z","timestamp":1748430197000},"page":"822-825","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the use of millipore filters to prevent post-injection endophthalmitis: A proof-of-concept in-vitro study"],"prefix":"10.4103","volume":"73","author":[{"given":"Devesh","family":"Kumawat","sequence":"first","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishat H","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Ocular Microbiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"R1-20260422","doi-asserted-by":"crossref","first-page":"e022031","DOI":"10.1136\/bmjopen-2018-022031","article-title":"Anti-vascular endothelial growth factor treatment for retinal conditions: A systematic review and meta-analysis","volume":"9","author":"Pham","year":"2019","journal-title":"BMJ Open"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"88","DOI":"10.4103\/0301-4738.126189","article-title":"Changing paradigms of anti-VEGF in the Indian scenario","volume":"62","author":"Shanmugam","year":"2014","journal-title":"Indian J Ophthalmol"},{"key":"R3-20260422","doi-asserted-by":"crossref","first-page":"441","DOI":"10.4103\/0301-4738.36479","article-title":"The economic implications of the use of anti-vascular endothelial growth factor drugs in age-related macular degeneration","volume":"55","author":"Azad","year":"2007","journal-title":"Indian J Ophthalmol"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"e018289","DOI":"10.1136\/bmjopen-2017-018289","article-title":"A longitudinal study to assess the frequency and cost of antivascular endothelial therapy, and inequalities in access, in England between 2005 and 2015","volume":"7","author":"Hollingworth","year":"2017","journal-title":"BMJ Open"},{"key":"R5-20260422","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40135-013-0033-1","article-title":"Endophthalmitis associated with intravitreal anti-vascular endothelial growth factor injections","volume":"2","author":"Schwartz","year":"2014","journal-title":"Curr Ophthalmol Rep"},{"key":"R6-20260422","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s40942-015-0010-y","article-title":"Endophthalmitis following intravitreal anti-vascular endothelial growth factor (VEGF) injection: A comprehensive review","volume":"1","author":"Merani","year":"2015","journal-title":"Int J Retina Vitreous"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"694","DOI":"10.4103\/0301-4738.99855","article-title":"Cluster endophthalmitis following multiple intravitreal bevacizumab injections from a single use vial","volume":"64","author":"Khan","year":"2016","journal-title":"Indian J Ophthalmol"},{"key":"R8-20260422","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s40942-021-00287-8","article-title":"Clinical management of an outbreak of nutritionally variant streptococcus endophthalmitis following intravitreal bevacizumab injection","volume":"7","author":"Barnes","year":"2021","journal-title":"Int J Retina Vitreous"},{"key":"R9-20260422","first-page":"e36769","article-title":"Endophthalmitis after intravitreal bevacizumab (avastin) injections: An outbreak investigated","volume":"15","author":"Shoaib","year":"2023","journal-title":"Cureus"},{"key":"R10-20260422","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1016\/j.ophtha.2012.12.009","article-title":"Streptococcus endophthalmitis outbreak after intravitreal injection of bevacizumab: One-year outcomes and investigative results","volume":"120","author":"Goldberg","year":"2013","journal-title":"Ophthalmology"},{"key":"R11-20260422","doi-asserted-by":"crossref","first-page":"545","DOI":"10.4103\/ijo.IJO_431_17","article-title":"Using intravitreal bevacizumab (Avastin\u00ae)-Indian Scenario","volume":"65","author":"Kumar","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"R12-20260422","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/0002-9394(60)90855-2","article-title":"Use of millipore filters in ophthalmic surgery","volume":"50","author":"Drews","year":"1960","journal-title":"Am J Ophthalmol"},{"key":"R13-20260422","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1038\/eye.1988.121","article-title":"Behaviour of intraocular gases","volume":"2","author":"Jacobs","year":"1988","journal-title":"Eye (Lond)"},{"key":"R14-20260422","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1093\/ajcp\/28.5_ts.565","article-title":"The use of millipore filters in clinical laboratories","volume":"28","author":"Wayne","year":"1957","journal-title":"Am J Clin Pathol"},{"key":"R15-20260422","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1093\/ajcp\/27.1_ts.117","article-title":"Use of Millipore membrane filter in the diagnostic tuberculosis laboratory","volume":"27","author":"Haley","year":"1957","journal-title":"Am J Clin Pathol"},{"key":"R16-20260422","first-page":"1355","article-title":"Effect of filtration on complications of postoperative intravenous therapy","volume":"36","author":"Rusho","year":"1979","journal-title":"Am J Hosp Pharm"},{"key":"R17-20260422","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1136\/bmj.4.5890.456","article-title":"Effect of a Millipore filter on complications of intravenous infusions: A prospective clinical trial","volume":"4","author":"Collin","year":"1973","journal-title":"Br Med J"},{"key":"R18-20260422","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/S0886-3350(86)80120-1","article-title":"Particulate and microbial contamination of intraocular irrigation solutions","volume":"12","author":"Neumann","year":"1986","journal-title":"J Cataract Refract Surg"},{"key":"R19-20260422","first-page":"1921","article-title":"Membrane filters and membrane-filtration processes for health care","volume":"40","author":"Eudailey","year":"1983","journal-title":"Am J Hosp Pharm"},{"key":"R20-20260422","first-page":"319","article-title":"Intravenous in-line filters: Filtering the evidence","volume":"6","author":"Ball","year":"2003","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"R21-20260422","first-page":"916","article-title":"A filter paper culture technique for the early detection of microcolonies of tubercle bacilli","volume":"70","author":"Hoyt","year":"1954","journal-title":"Am Rev Tuberc"},{"key":"R22-20260422","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S0146-2776(81)80062-6","article-title":"Millipore filters in ophthalmic surgery: A caution concerning their use","volume":"7","author":"Meltzer","year":"1981","journal-title":"J Am Intraocul Implant Soc"},{"key":"R23-20260422","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1001\/archopht.121.11.1663-a","article-title":"Endophthalmitis after intravitreal injection of triamcinolone acetonide","volume":"121","author":"Jonas","year":"2003","journal-title":"Arch Ophthalmol"},{"key":"R24-20260422","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/S0002-9394(03)00483-5","article-title":"Acute endophthalmitis following intravitreal triamcinolone acetonide injection","volume":"136","author":"Moshfeghi","year":"2003","journal-title":"Am J Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_3071_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:55:14Z","timestamp":1786647314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_3071_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_3071_24","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]},"assertion":[{"value":"2024-12-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-14","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}