Purchase this article with an account.
Aleksandra Rachitskaya, Harry W. Flynn, Jr., Fiona Ehlies, Maria B. Ayres, Timothy G. Murray; Correlation of Baseline Echographic Features with Visual Acuity and Microbiological Culture Outcomes in Patients with Clinically Diagnosed Endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5604.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To identify and correlate the echographic features with visual acuity (VA) outcomes and microbiological culture results in patients with clinically diagnosed endophthalmitis.
The current study is a retrospective non-comparative case series of 120 patients with clinical diagnosis of endophthalmitis and a baseline echographic exam from 1996 to 2007 at a single institution. We compared graded echographic features with VA and culture outcomes. Echographic features studied included 1) absent, mild, moderate, and dense vitreous opacities 2) absent, mild, moderate, and dense vitreous membranes 3) retinal detachment (RD) and 4) choroidal detachment (CD). Initial, 1 month, 3 months, 12 months, and last VA were recorded. Final VA was defined as either VA at 12 months or last recorded, whichever came earlier. The cultures were performed at our institution.
Out of 120 patients, 42% of patients achieved a VA outcome of count fingers or better. Dense vitreous opacities were present in 52% of the cases, dense vitreous membranes in 42%, RD in 27%, and CD in 23%. Among these four parameters, dense vitreous membranes and RD correlated the strongest with the worse final VA (p <0.005 ). Positive cultures were identified in 72.5% of patients and included: Coagulase-negative staphylococcus species (22%), Fungal species (15%), Staphylococcus aureus (14%), Streptococcus species (13%), Pseudomonas species (11%), other gram positive bacteria (10%), other gram negative bacteria (10%), and Enterococcus species (5%). More virulent organisms (Streptococcus species, Pseudomonas species, other gram negative bacteria, and Enterococcus species) with visual outcomes ranging from LP to NLP were compared to less virulent organisms (Staphylococcus aureus, Fungal species, Coagulase-negative Staphylococcus species, and other gram positive bacteria). The more virulent organisms had more dense vitreous membranes (70% vs. 38%), vitreous opacities (61% vs. 24%), RD (25% vs. 20%), and CD (33% vs. 16%) as compared to less virulent organisms.
Baseline echographic features of dense vitreous opacities, dense vitreous membranes, RD, and CD correlated with worse final VA and more virulent organisms in patients with clinically diagnosed endophthalmitis.
This PDF is available to Subscribers Only