Purchase this article with an account.
H. Wilson, D. Mayor, J. Fan; Endogenous Endophthalmitis: A Six-Year Review in a California Tertiary Care Center. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3556.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the predisposing medical conditions, causative organisms, management, as well as visual and systemic outcomes in endogenous endophthalmitis.
An exhaustive system-wide search was done to identify all patients with a diagnosis of endopthhalmitis treated at Loma Linda University Medical Center from October 2002 to July 2008. Through retrospective chart review, 17 patients (21 eyes) were identified with endogenous endophthalmitis. Follow-up ranged from 7 days to 17 months.
Systemic predisposing conditions were primarily diabetes (62%), malignancy (12%), and autoimmune disease (12%). The source of infection was most often bacteremia of uncertain source (35%), followed by meningitis, pneumonia, and urinary tract infection. The majority (88%) of the patients underwent pars plana vitrectomy and the remainder underwent vitreous biopsy without vitrectomy. All patients received intravitreal antibiotics. Six patients (36%) had positive vitreous cultures. Of these, Staphylococcus aureus (4/6) was the most common isolated organism. Other isolates included Candida, Coagulase negative staphylococcus, and Klebsiella/Enterobacter sp. Presenting visual acuity was 20/200 or lower in all patients. Final visual improvement of one or more lines was noted in three patients (18%). Visual acuity declined in six patients (35%). The most common visual complication was retinal detachment (35%). Corneal ulceration (1), subretinal abscesses(1), and intractable pain requiring enucleation were also seen. Three patients (18%) died within one month of diagnosis, and another within three years of diagnosis.
Contrary to other published series of endogenous endophthalmitis, our patient population was more likely to have bacterial isolates (instead of fungal) with a predominance of Staphylococcus aureus. Similar to the current consensus, we found that endogenous endophthalmitis is consistently associated with poor visual prognosis and high mortality.
This PDF is available to Subscribers Only