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T. W. Eck, N. Chandrasekaran, M. A. Zarbin, D. S. Chu, P. D. Langer, N. Bhagat; Corneal Ulcer-Associated Endophthamitis: A Retrospective Review. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6044.
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© ARVO (1962-2015); The Authors (2016-present)
To identify characteristics, pathogens, and outcomes in eyes with corneal ulcer-associated endophthalmitis at New Jersey Medical School (NJMS).
Retrospective case series. Medical records of all infectious endophthalmitis patients were reviewed to identify those who presented with concurrent infectious corneal ulcers between 1997 and 2008.
Thirty-one eyes of thirty-one patients were identified. Seventeen were male, and fourteen female. Mean age at presentation was 67.5 years. Race demographics were Caucasian (11), African American (7), Hispanic (6), South Asian (2), and Portuguese (1), with four unknown. Fourteen eyes were phakic, 13 pseudophakic, and 4 aphakic. At presentation, 15 of 31 eyes (48 %) had perforated cornea. Sixteen eyes presented with no light perception vision. Cultures were taken from 17 patients at presentation and from 30 during their hospital stay. Sampling methods included corneal scraping (4), corneal scraping with intravitreal biopsy (3), aqueous biopsy with corneal scraping (2), and aqueous biopsy with intravitreal biopsy (2). The organisms most commonly cultured were S. aureus (5), S. epidermidis (4), and P. aeruginosa (3). Thirteen of 31 eyes received intravitreal antibiotics (the most common being vancomycin and ceftazidime) as the first line of treatment. The remaining 18 eyes were enucleated soon after presentation. Of these 18, 16 presented with NLP vision, one presented with LP vision, and one was unable to be assessed.Twenty-one eyes (68 %) were admitted for IV antibiotics. The length of inpatient stay ranged from 0 days to 21 days, with a mean of 5.6 days. Of the 21 patients who received intravenous antibiotics, 10 were administered vancomycin and ceftazidime.Average VA at presentation LogMAR, was 2.61 (n = 30). Excluding 5 patients with less than 3 months follow-up, final VA was 2.64 at 3 months. Of these 26 patients, two achieved a visual acuity of better than 20/400. NLP = 3.0, LP = 2.5, HM = 2.0, and CF = 1.6. Note: Vision for enucleated eye treated as NLP.
Corneal-ulcer related endophthalmitis has a poor anatomic and functional outcome. In our series, 58% of eyes underwent enucleation. The average Snellen VA of the remaining 42% was HM (logMAR 2.01).
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