April 2009
Volume 50, Issue 13
ARVO Annual Meeting Abstract  |   April 2009
Endogenous Endophthalmitis: A Six-Year Review in a California Tertiary Care Center
Author Affiliations & Notes
  • H. Wilson
    Loma Linda Univ Med Center, Loma Linda, California
  • D. Mayor
    School of Medicine,
    Loma Linda Univ Med Center, Loma Linda, California
  • J. Fan
    Ophthalmology - VitreoRetinal Service,
    Loma Linda Univ Med Center, Loma Linda, California
  • Footnotes
    Commercial Relationships  H. Wilson, None; D. Mayor, None; J. Fan, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 3556. doi:
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      H. Wilson, D. Mayor, J. Fan; Endogenous Endophthalmitis: A Six-Year Review in a California Tertiary Care Center. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3556.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To evaluate the predisposing medical conditions, causative organisms, management, as well as visual and systemic outcomes in endogenous endophthalmitis.

Methods: : An exhaustive system-wide search was done to identify all patients with a diagnosis of endopthhalmitis treated at Loma Linda University Medical Center from October 2002 to July 2008. Through retrospective chart review, 17 patients (21 eyes) were identified with endogenous endophthalmitis. Follow-up ranged from 7 days to 17 months.

Results: : Systemic predisposing conditions were primarily diabetes (62%), malignancy (12%), and autoimmune disease (12%). The source of infection was most often bacteremia of uncertain source (35%), followed by meningitis, pneumonia, and urinary tract infection. The majority (88%) of the patients underwent pars plana vitrectomy and the remainder underwent vitreous biopsy without vitrectomy. All patients received intravitreal antibiotics. Six patients (36%) had positive vitreous cultures. Of these, Staphylococcus aureus (4/6) was the most common isolated organism. Other isolates included Candida, Coagulase negative staphylococcus, and Klebsiella/Enterobacter sp. Presenting visual acuity was 20/200 or lower in all patients. Final visual improvement of one or more lines was noted in three patients (18%). Visual acuity declined in six patients (35%). The most common visual complication was retinal detachment (35%). Corneal ulceration (1), subretinal abscesses(1), and intractable pain requiring enucleation were also seen. Three patients (18%) died within one month of diagnosis, and another within three years of diagnosis.

Conclusions: : Contrary to other published series of endogenous endophthalmitis, our patient population was more likely to have bacterial isolates (instead of fungal) with a predominance of Staphylococcus aureus. Similar to the current consensus, we found that endogenous endophthalmitis is consistently associated with poor visual prognosis and high mortality.

Keywords: endophthalmitis • retina 

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