Abstract
Purpose :
The treatment of endophthalmitis consists of intravitreal antibiotics injections and, in selected circumstances, pars plana vitrectomy. However, severe or refractory cases may require an enucleation or evisceration (ENEV) to control the infectious process. Our study seeks to identify risk factors leading to enucleation or evisceration in patients with infectious endophthalmitis.
Methods :
Medical records covering from August 2015 to August 2020 in a tertiary referral hospital in Puerto Rico were reviewed. Charts of patients with a clinical diagnosis of infectious endophthalmitis were selected for analysis. Affected eyes were stratified into two groups; those undergoing ENEV and those in which the globe was preserved (EP). Accordingly, the frequencies of clinical characteristics in each of the two groups were compared and statistically analyzed using Pearson’s Chi-square test, Fisher’s exact test, and Welch Two Sample t-test.
Results :
A total of 69 patients diagnosed with endophthalmitis were identified and included in our study, of which 32 underwent ENEV. The median age was 70, and 40.6% were female. There was a higher frequency of exogenous endophthalmitis in the ENEV group versus the EP group (56.2% and 13.5%, p=0.0002). However, there was a lower post-surgical endophthalmitis frequency in the ENEV versus the EP groups (21.9% vs. 51.4%, p=0.014). A visual acuity of no light perception was most common in the ENEV vs. the EP group (46.9% vs. 5.4%, p= 0.00003). While a visual acuity of finger counting or better was less common in the ENEV group vs. the EP group (9.4% vs. 32.4%, p= 0.04). Orbital involvement (panophthalmitis) was more frequent in the ENEV versus the EP group (37.5% vs. 5.4%, p= 0.002).
Conclusions :
Our study suggests that eyes with endophthalmitis that present with a visual acuity of no light perception, panophthalmitis, or exogenous etiology have a higher risk of ENEV. Conversely, patients with a post-surgical etiology or a visual acuity of finger counting or better may be at a lower risk of ENEV.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.