Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
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.
This PDF is available to Subscribers Only