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Chang Sup Lee, Asima Bajwa, Jim Patrie, Miraj Khan, Yevgeniy Shildkrot; Visual outcomes of endophthalmitis patients who underwent pars plana vitrectomy in regards to microbiology culture status.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5522.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the visual outcome of culture positive and culture negative endophthalmitis patients who underwent pars plana vitrectomy (PPV) at a tertiary eye center in central Virginia.
Retrospective, observational study of 32 patients (50% male) who underwent PPV at the University of Virginia from 2000-2014. Mean age was 67.1 years (SD=17.8) [range: 22.8 to 93.7 years] at the time of surgery. All patients with a minimum of 1 month follow up and vitreous biopsy culture data were included. Linear mixed models were utilized to compare best-corrected visual acuity (BCVA) as measured by logMAR between culture-positive and culture-negative individuals with adjustments for age and pre-surgery BCVA.
Twenty-six (81%) out of 32 cases were positive for culture. The mean BCVA logMAR for individuals with culture-negative endophthalmitis was 2.70 (95% CI:[2.06, 3.34]) at pre-surgery state and 0.38 [-0.66, 1,42] after 12 months of surgery. The mean BCVA logMAR for individuals who had positive microbiology cultures was 2.58 [2.26, 2.90] at pre-surgery state and 1.67 [1.11, 2.24] after 12 months of surgery (Table 1).After adjustment for patient age and pre-surgery BCVA, there was a significant association between post-operative BCVA and microbiology culture status (p<0.001). Further analysis after Bonferroni correction for multiple comparisons revealed that the post-operative mean BCVA logMAR at 1 and 3 months were significantly greater for individuals who had a positive microbiology cultures than for individuals who had negative cultures (P=0.002, and P=0.003, respectively). At month 12, mean BCVA was marginally greater for the individuals who had a positive microbiology cultures than for individuals who had negative cultures (P=0.069) (Table 2).
Individuals with culture-negative endophthalmitis showed significantly greater improvement in BCVA when compared to those with culture-positive results. The BCVA differed between culture positive and culture negative individuals at month 1 (p=0.002) and month 3 (p=0.003) and marginally at month 12 (p=0.069).
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Table 1. Unadjusted mean BCVA logMAR (i.e. not adjusted for age and pre-surgery logMAR).
Table 2. Age and pre-surgery BCVA logMAR adjusted comparisons of post-surgery BCVA logMAR between culture positive and culture negative individuals.
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