Abstract
Purpose :
To describe the clinical presentations, management and factors determining outcomes of Aspergillus endophthalmitis.
Methods :
Retrospective, interventional, multi-centric case series. The study included 91 eyes of 91 patients with culture-proven Aspergillus endophthalmitis. Anterior chamber fluid and/or vitreous and/or intraocular lens were submitted for microbiological evaluation in all cases. The data analysis included patient demography, clinical presentations, interventions and final treatment outcomes. The main outcome measures were the final visual acuity and the globe salvation. The factors determining better visual and/or anatomical outcomes were analyzed.
Results :
The mean age of the patients was 39.71±20.16 years (median 40 years, range 3-76 years). By etiology the primary event before the endophthalmitis was trauma (42; 46.15%) eyes, cataract surgery (acute-onset: 30; 32.96% and delayed-onset: 6; 6.59%) eyes, endogenous (10; 10.98%) eyes and cornea surgery (3; 3.29%) eyes. The mean follow was 5.78±6.74 months (median 3, range 0.5-40 months). The odds of a favorable visual outcome were presenting vision > hand motions (OR = 3.33, p=0.02), absence of corneal infiltrate (OR=5.4, p=0.03), vitrectomy instead of a vitreous tap only (OR=4.26, p=0.03), administration of intravitreal voriconazole (OR=3.63, p=0.02) and absence of fungal elements on primary microscopy (OR= 3.42, p=0.02).
Conclusions :
Early vitrectomy and intravitreal voriconazole yielded better anatomic and functional outcomes in Aspergillus endophthalmitis. Favorable visual outcome was achieved in a fifth of the eyes and globe was salvaged in two thirds of the eyes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.