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Avinash Pathengay, Vivek Dave, Nidhi Relhan, Rajeev Pappuru, Harry W Flynn, Taraprasad Das; Endophthalmitis and Concurrent or Delayed-onset Rhegmatogenous Retinal Detachment managed with Silicone Oil. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5508.
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© ARVO (1962-2015); The Authors (2016-present)
Management outcomes of retinal detachment in the setting of endophthalmitis using silicone oil tamponade are not well described. We performed a retrospective observational study to describe the demographics, clinical presentations, anatomic and visual outcomes of endophthalmitis with con-current or delayed onset retinal detachment managed with silicone oil injection.
The patient database in the Medical Records Department with diagnosis code “endophthalmitis” and "rhegmatogenous retinal detachment" over a time period between January 1990 and December 2014 was identified. The patients were classified in group 1 – patients having RD at presentation (Concurrent RD group) and group 2 – patients developing RD during follow up (Delayed-onset RD group). All patients received silicone oil for the management of retinal detachment immediately or during follow-up . Anatomical success was defined as retina attached completely at the last visit. Functional success was defined as the best corrected visual acuity of 20/400 or better at the last visit. The data was analyzed using MedCalc ver 188.8.131.52 statistical software. A p value of <0.05 was assigned as statistically significant.
A total of 93 patients were included in the current study. The table below describes the outcomes.Group 1 – N=20 patients(Concurrent RD) (21.5%)Group 2 – N=73 patients(Delayed-onset RD) (78.5%)p valueInitial TreatmentVitreous tap + IOABPPV + IOABPPV + IOAB + SOINone1/20 (5%)19/20 (95%)14/73 (19.2%)55/73 (75.3%)4/73 (5.5%)PPV + SOI (during follow-up)1/2073/73<0.0001Recurrent RD7/2022/730.88SOR9/2035/730.9Anatomical Successa(Complete retinal attachment at 4 months)14/19* (73.7%)66/67** (98.5%)0.001Functional Successb(Visual acuity ≥ 20/400 at 4 months)6/20 (30%)29/73 (39.7%)0.59Follow-up duration (months)36.8±53.7(range 4- 168)22.6±31.6(range 4-180)0.13a-p value=, b-p value=, *data available for 19 patients, **data available for 67 patients, RD-retinal detachment, IOAB – intravitreal antibiotics, PPV – pars plana vitrectomy, SOI – silicone oil injection
Retinal detachment associated with endophthalmitis is associated with poor anatomic and visual outcomes especially in the concurrent presentation.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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