Abstract
Abstract: :
Purpose: To describe the echographic findings following vitreous biopsy and intravitreal antibiotic injection. Previously, echographic findings on initial presentation have been described in infectious endophthalmitis. Some of these studies have reported prognostic indicators of poor visual outcome based on the initial echography (Dacey et al). To date, there have been no studies to our knowledge exploring the echographic findings following vitreous biopsy and intravitreal antibiotic injection in endophthalmitis. Methods: Retrospective case series involving 18 eyes with endophthalmitis that underwent vitreous biopsy and intravitreal antibiotic injections. Echography was performed in all eyes following the procedure. Results: Nine male and nine female patients with an average age of 68.2 years (range=44–88) underwent vitreous biopsy and intravitreal antibiotic injection for endophthalmitis. Standardized B–scan ultrasonography was performed a mean of 6.6 days later (range=1–25) by a single, experienced ultrasonographer (KG). The clinical circumstances included recent cataract surgery in 12 patients (67%), blebitis in 5 patients (28%), and endogenous endophthalmitis in 1 patient (6%). Poor initial visual acuity (hand motions or worse) was seen in 13 of 18 patients (72%). During an average of 34.4 weeks of follow–up (range=2–161), ten of the eighteen patients (56%) attained good visual acuity (20/100 or better). There was a higher frequency of echographic abnormalities among patients with poor final visual acuity compared to patients with good final visual acuity. Retinal detachments occurred in 4 of 7 patients (57.1%) with poor final visual acuity and only 1 of 10 patients (10%) with good final visual acuity. Ciliochoroidal detachments occurred in 3 of 7 patients (42.9%) with poor final visual acuity and only 1 of 10 patients (10%) with good final visual acuity. Macular thickening was noted in 2 of 7 patients (28.6%) with poor final visual acuity and 2 of 10 patients (20%) with good final visual acuity. Conclusions: Following vitreous biopsy and intravitreal antibiotic injection for endophthalmitis, echographic abnormalities including retinal detachments, ciliochoroidal detachments, and macular thickening seem to be associated with poorer visual outcomes. Echography is useful for following these eyes to monitor for posterior segment changes that may not only serve a prognostic function but may also require further intervention.
Keywords: endophthalmitis • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)