Abstract
Purpose: :
To describe and compare the causative organisms, clinical features and visual outcomes of endophthalmitis following intravitreal injection (IVI) to endophthalmitis following cataract surgery (CS).
Methods: :
Retrospective case series.Patient Population & Setting: Patients with acute endophthalmitis following either CS or IVI presenting to a tertiary referral centre - Sydney Eye Hospital - between 2007 and 2010. Main outcome measures: 1. identification of the causative organism; 2. time to presentation; 3. odds of improvement in visual acuity following treatment; 4. odds of final visual acuity of counting fingers or less and 5. odds of enucleation.
Results: :
Of the 101 patients in this study, 48 had preceding CS and 53 had preceding IVI. There was an increased incidence of Streptococcus spp. endophthalmitis in post IVI cases (24.53% versus 6.25%; odds ratio (OR) 5.85; P = 0.022). Endophthalmitis following IVI had increased likelihood of a final visual acuity of counting fingers or less (OR = 6.0; P < 0.01), decreased likelihood of any improvement in acuity following treatment (OR = 0.13; P <0.01) and an increased likelihood of presenting within a week of the procedure (OR = 3.93; P <0.01). Streptococcus spp. endophthalmitis was associated with increased likelihood of a final visual acuity of counting fingers or less (OR = 10.2; P < 0.01), decreased likelihood of any improvement in acuity following treatment (odds ratio = 0.06; P < 0.01) and increased likelihood of enucleation (OR = 17.11; P < 0.01).
Conclusions: :
Post IVI endophthalmitis is associated with an increased incidence of Streptococcus spp. infection, earlier presentation and poorer visual outcomes when compared to post CS endophthalmitis.
Keywords: endophthalmitis • injection • antibiotics/antifungals/antiparasitics