June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Endogenous Endophthalmitis in the American and Korean Population : An Eight-year Retrospective Study
Author Affiliations & Notes
  • Heeyoon Cho
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
    Ophthalmology, Hanyang University Medical College, Seoul, Korea (the Republic of)
  • Nicole Hauptman Siegel
    Ophthalmology, Boston University School of Medicine, Boston, MA
  • Hyeong Gon Yu
    Ophthalmology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Lucia Sobrin
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
  • Achal Patel
    Ophthalmology, Boston University School of Medicine, Boston, MA
  • Han Woong Lim
    Ophthalmology, Hanyang University Medical College, Seoul, Korea (the Republic of)
  • Marlene Durand
    Infectious Disease Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • Joan W Miller
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
  • Deeba Husain
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
  • Footnotes
    Commercial Relationships Heeyoon Cho, None; Nicole Siegel, None; Hyeong Gon Yu, None; Lucia Sobrin, None; Achal Patel, None; Han Woong Lim, None; Marlene Durand, None; Joan Miller, None; Deeba Husain, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4169. doi:
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      Heeyoon Cho, Nicole Hauptman Siegel, Hyeong Gon Yu, Lucia Sobrin, Achal Patel, Han Woong Lim, Marlene Durand, Joan W Miller, Deeba Husain; Endogenous Endophthalmitis in the American and Korean Population : An Eight-year Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4169.

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Abstract
 
Purpose
 

To study the clinical features, epidemiological factors and treatment outcomes of endogenous endophthalmitis and compare these characteristics in sample patient populations from the United States and Korea over an eight-year period

 
Methods
 

We conducted a retrospective chart review of patients diagnosed with endogenous endophthalmitis from January 2006 to December 2013, who were referred to tertiary referral centers in the United States and South Korea. We compared clinical characteristics between Korean and American patients. We also compared the visual outcomes in patients who underwent vitrectomy vs. those who did not have a vitrectomy.

 
Results
 

128 eyes of 108 patients with endogenous endophthalmitis were included. Sixty patients were American and 41 patients were Korean. Fungemia related to illicit intravenous drug use or an indwelling central venous catheter was a more common extraocular infection source among American patients than in Korean patients (26.7% vs. 6.3%, p=0.006). In contrast, liver abscess was overwhelmingly more common among Korean patients vs. American patients (33.3% vs 0%). Gram negative bacteria, especially Klebsiella pneumoniae, was the most common causative organism of endogenous endophthalmitis in the Korean population, whereas fungi were the most common etiologies in the American population. Among the 65 eyes with endogenous bacterial endophthalmitis(EBE), 13 eyes underwent immediate vitrectomy within 24 hours after diagnosis; 31% of these cases had presenting visual acuity of LP while only 15% had >CF. In contrast, 52% of the no vitrectomy group had >CF vision on presentation. There was no significant difference in the final visual outcome or degree of visual improvement between the vitrectomy group and the no-vitrectomy group. The final visual acuities of EBE were 20/50 or better in 17(26.2%) of 65 eyes. Endophthalmitis cases caused by fungi had a better visual prognosis than those caused by bacteria (p<0.001).

 
Conclusions
 

The predisposing conditions and responsible organisms for endogenous endophthalmitis varies in different regions of the world. Although endogenous endophthalmitis is generally associated with poor visual acuity outcomes, the prognosis appears to depend mainly on the pathogen. Early vitrectomy was not associated with a better visual prognosis in this study, but results were confounded by presenting visual acuity and pathogen virulence.  

 

 
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