New Onset Diabetic Retinopathy After Endophthalmitis

Abstract

Abstract: : Purpose: Endophthalmitis has been associated with the progression of pre-existing diabetic retinopathy. The purpose of this study was to determine if endophthalmitis is associated with the development of new onset diabetic retinopathy. Methods: Retrospective review of 36 consecutive cases of endophthalmitis treated by one vitreoretinal surgeon at Kresge Eye Institute between 1997 and 2000. Pre-existing retinopathy status and presenting visual acuity were recorded. Retinopathy status and visual acuity at most recent follow-up visit were assessed. Development of retinopathy attributable to endophthalmitis was considered to occur when only the infected eye showed diabetic retinopathy. Results: Of 36 cases of endophthalmitis, 11 occurred in diabetic patients. Seven of these patients had no pre-existing diabetic retinopathy and had follow-up of at least 6 months. These patients were selected for further analysis. Four patients developed unilateral diabetic retinopathy in the infected eye within 5 months (3 patients with diabetic macular edema, 1 patient with neovascular glaucoma). Final visual outcome in these patients was poor, ranging from 20/40 to no light perception. Of the three additional diabetic patients without pre-existing retinopathy, two developed bilateral symmetric diabetic retinopathy, but with a later onset (24 mos - 27 mos). Conclusions: Diabetic patients with endophthalmitis are at high risk for new onset diabetic retinopathy in the affected eye. The retinopathy typically occurs within several months and is frequently associated with a poor visual outcome. Diabetic patients should be monitored closely after endophthalmitis, even in the absence of pre-existing diabetic retinopathy.

Keywords: diabetic retinopathy • endophthalmitis