June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Culture-positive endophthalmitis after open globe injuries with and without retained intraocular foreign bodies
Author Affiliations & Notes
  • Julia Lynne Hudson
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Jason Fan
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Kenneth Fan
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Darlene Miller
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Harry W Flynn
    University of Miami Mary and Edward Norton Library of Ophthalmology, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Julia Hudson, None; Jason Fan, None; Kenneth Fan, None; Darlene Miller, None; Harry Flynn, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1355. doi:
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    • Get Citation

      Julia Lynne Hudson, Jason Fan, Kenneth Fan, Darlene Miller, Harry W Flynn; Culture-positive endophthalmitis after open globe injuries with and without retained intraocular foreign bodies. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1355.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report on the microbial spectrum and clinical features affecting final visual acuity (VA) outcome in cases of culture-positive endophthalmitis after open globe injury.

Methods : A non-comparative, retrospective, consecutive case series. All patients were diagnosed with endophthalmitis between January 2016 and January 2020 at the Bascom Palmer Eye Institute. Culture-positive isolates from patients with history of open globe injury were identified. Variables included demographic information, time to diagnosis, mechanism of injury, causative organism, and VA outcomes.

Results : Eleven cases of culture-positive endophthalmitis after open globe injury were identified. All patients were male and average age at time of injury was 35.65 years. Penetrating trauma was the mechanism of injury in all cases. Treatment selected included intravitreal antimicrobials in 11 cases, initial pars plana vitrectomy in 8 cases, and silicone oil in 4 cases. Primary evisceration or enucleation was not performed in any patient.

Seven cases of endophthalmitis (64%) were clinically diagnosed prior to open globe repair, whereas 4 cases (36%) developed endophthalmitis after open globe repair. The average time from globe injury to presentation was 7.3 days (range 0 to 42 days). Six cases were associated with an intraocular foreign body (IOFB). Of these, 4 were metallic and 2 were composed of vegetable matter.

Coagulase-negative staphylococcus accounted for the majority of cases (55%, 6/11). Isolates included Staphylococcus epidermidis (n=5) and Staphylococcus hominis (n=1). Virulent organisms represented the remainder of cases and isolates included: Streptococcus mitis (n=1), and Bacillus cereus (n=1), Fusarium (n=1), Colletotrichum gloeosporiodes (n=1), and Enterobacter cloacae (n=1).

The mean presenting VA was HM (LogMAR 2.25) and the final average VA was similarly HM (LogMar 2.1) and included 3 enucleations. For patients without an IOFB the mean VA was CF (LogMAR 1.88), as compared to HM (LogMar 2.2) in cases of IOFB.

Conclusions : In agreement with prior studies on open globe injuries, we found coagulase-negative staphylococcus to be the most commonly isolated organism in cases of culture-positive endophthalmitis. In the current study, delayed presentation to care was a common factor in the development of endophthalmitis. VA outcomes for these patients with open-globe related endophthalmitis is generally poor.

This is a 2021 ARVO Annual Meeting abstract.

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