Abstract
Purpose :
To report the clinical presentations, microbiology, management outcomes of endogenous endophthalmitis and a comparison with similar cohorts worldwide
Methods :
Retrospective chart review of culture-positive cases of endogenous endophthalmitis. The clinical presentations, microbiology, culture sensitivity and management outcomes were noted. A comparison was made with representative largest available series from other parts of the world
Results :
One seventy three eyes were included. The mean age was 25.41±20.46 years (median 24 years). There was no pre-disposing systemic illness in 117 (67.63%) cases. The commonest predisposing systemic condition was pyrexia of unknown origin, 18 (10.4%). Commonest presenting visual acuity range was perception of light to hand motions, 107 eyes (61.84%). Favorable vision (≥20/400) at presentation was noted in 4 eyes and at the last visit in 45 eyes. The commonest organism isolated was Streptococcus pneumoniae (36 eyes, 20.8%). Fungus accounted for 24 eyes (13.87%). Compared to a recent large series, the primary source of infection was identified only in 32% versus 75% (p<0.0001), systemic symptoms were identified in 23% versus 70% (p<0.0001), blood culture positivity was 0.57% versus 42% (p<0.0001), urine culture positivity was in 6.35% versus41% (p<0.0001), vitreous culture positivity was seen in 93% versus 22% (p<0.0001), gram-negative etiology was seen in 37% versus 80% (p<0.0001), phthisis bulbi was seen in 38% versus 7% (p<0.0001). There was no difference in the comparative outcomes where the predisposing source of infection was either identified or not identified (p=0.3).
Conclusions :
Endogenous endophthalmitis in India commonly presents in young individuals without any underlying systemic illness. Commonly done serological testing is often negative. Endogenous endophthalmitis is commonly caused by Gram-positive bacteria in our setting. Final function and anatomic outcome is poor
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.