Retinal detachment caused by endophthalmitis: a retrospective case series study

Abstract

Purpose : The present study reports patients with endophthalmitis-related retinal detachment (RD) managed with vitrectomy.

Methods : The present study included consecutive eyes who had surgery for endophthalmitis-related RD at CHU de Quebec – Université Laval (Canada) between April 2009 and November 2019. The data were collected retrospectively. The main variables were: etiology of endophthalmitis, classified into endogenous and exogenous (posttraumatic, corneal ulcer, post cataract surgery and post intraocular injection), causing microorganisms found in the intraocular fluid (IOF), type and description of RD, best corrected visual acuity (BCVA) after vitrectomy, and retina status at final follow up. The main outcomes were the final visual acuity and retina status at final follow up.

Results : 17 eyes (14 males and 3 females) were included in this study. The mean age was 59 ± 20 (17-97) years. We identified many types of RD (8 tractional RD, 6 total RD, 2 rhegmatogenous RD, and 1 serous RD). Microorganisms were detected in 14 cases out of 17 (82.4%): Staphylococcus epidermidis in 3 cases, Staphylococcus lugdunensis in 1 case, Propionibacterium acnes in 2 cases and Streptotoccus spp. in 3 cases (viridans, salivarius and pneumoniae). Concomitant microorganisms were found in 5 cases (Strep. B-hemolytic group G + Staphylococcus epidermidis, Propionibacterium acnes + Staphylococcus epidermidis + mycogenous elements, Streptococcus pyogenes + Staphylococcus epidermidis + Propionibacterium acnes, Streptococcus oralis + Streptococcus mitis and Staphylococcus saprophyticus + Staphylococcus warneri). The mean follow up duration was 13 months. The BCVA at last follow up was variable: 1 patient (5.9%) had a BCVA ≥ 20/40, 6 patients (35.3%) had a BCVA between 20/40 and 20/400, 3 patients (17.6%) had a BCVA of counting fingers (CF), 4 patients (23.5%) had a BCVA of hand motions (HM), 2 patients (11.8%) had a BCVA of light perception (LP), and 1 patient (5.9%) had no light perception (NLP). 9 of 17 retina (52.9%) were successfully reattached, 5 of 17 retina (29.4%) were reattached with silicone oil, 1 retina was reattached with macular atrophy and 1 retina was reattached with macular fibrosis. One patient had evisceration of the eye.

Conclusions : Endophthalmitis-related RD is associated with poor visual acuity outcome (11 patients (64.7%) had CF, HM, LP or NLP as visual outcome) and microorganisms were frequently found in the IOF (71%).

This is a 2021 ARVO Annual Meeting abstract.