June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
The role of repeat vitreous tap/biopsy in the treatment of endophthalmitis
Author Affiliations & Notes
  • Katherine Donnithorne
    Ophthalmology, University of Alabama at Birmingham, Birmingham, AL
  • Robert Morris
    Retina Specialists of Alabama, Birmingham, AL
  • Matthew Oltmanns
    Retina Specialists of Alabama, Birmingham, AL
  • Footnotes
    Commercial Relationships Katherine Donnithorne, None; Robert Morris, None; Matthew Oltmanns, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4186. doi:
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      Katherine Donnithorne, Robert Morris, Matthew Oltmanns; The role of repeat vitreous tap/biopsy in the treatment of endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4186.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Debate exists regarding the optimal treatment of endophthalmitis. We performed a retrospective, observational clinical study to evaluate the utility of repeat vitreous tap/biopsy (VTB) to assess pathogen clearance in patients with endophthalmitis.

 
Methods
 

A retrospective chart review was conducted of all patients with endophthalmitis seen between 2001-2014 (inclusive) in a vitreoretinal specialist practice. Patients were included in the study if they had two or more VTB available during the endophthalmitis course.

 
Results
 

There were a total of 49 patients ranging between 8-99 years old who were included in the study. 9/49 (18%) of the patients underwent biopsy with injection of intravitreal antibiotics alone (TAP), while 40/49 (81%) underwent biopsy and intravitreal injection of antibiotics with pars plana vitrectomy (PPV). 17/49 (34%) of patients’ second VTB were positive, 2/9 (22%) from the TAP group and 15/40 (38%) from those that underwent PPV. 12/49 (24%) of second VTB pathogens reported were different from the first VTB results. Improvement in vision during the endophthalmitis course was noted in 4/9 (44%) of the TAP group vs. 20/40 (50%) of the PPV group.

 
Conclusions
 

There is an important role for repeat vitreous biopsies in the treatment of endophthalmitis. In addition, repeat antibiotic injection ensures therapeutic levels of medication to combat infection in the closed vitreous cavity. Optimal antibiotic concentration is key to combating the devastating sequelae of this condition.  

 
Intraoperative image of advanced endophthalmitis retinopathy.
 
Intraoperative image of advanced endophthalmitis retinopathy.
 
 
Fundus image taken of same patient's eye 3 weeks following surgery.
 
Fundus image taken of same patient's eye 3 weeks following surgery.

 
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