Abstract
Abstract: :
Purpose: To compare echographic findings in patients with infectious endophthalmitis with visual acuity and microbiologic outcomes. Methods: A retrospective consecutive case series of patients with a possible clinical diagnosis of post–operative, post–traumatic or endogenous endophthalmitis was performed on 235 patients at the Bascom Palmer Eye Institute between January 2000 and December 2004. Statistical analysis compared graded ultrasound findings with visual acuity and microbiology outcomes. The echographic findings included vitreous opacities, vitreous membranes, posterior vitreous detachment, retinal detachment, subretinal opacities, choroidal detachment, retino–choroidal thickening, optic nerve swelling and scleral thickening. Results:Over a 4 year period, 171 patients had echographic reports consistent with probable or possible endophthalmitis. Of patients with positive intraocular cultures, the following organisms were identified: Coagulase negative staphylococcus (24.0 %), Staphylococcus aureus (12.9 %), Streptococcus species (14.8 %), Enterococcus species (3.7%), gram negative species (30.0 %) and fungal species (18.5 %). All patients received intravitreal antibiotics or antifungals. The decision to use primary vitrectomy was made by the treating physician. Better visual acuity outcomes were correlated with less virulent organisms (Coagulase negative staphylococcus) and with less severe echographic findings (no retinal detachment, no choroidal detachment and less dense vitreous opacities). Conclusions: In patients with positive intraocular cultures, final visual acuity correlated with less virulent organisms. Detailed ocular echography provides useful clinical information regarding the absence of dense vitreous opacities, retinal detachment or choroidal detachment, which in turn correlated with better final visual acuity outcomes.
Keywords: microbial pathogenesis: clinical studies • endophthalmitis