Abstract
Purpose :
EE is characterized as an intraocular infection caused by hematogenous spread of microbes to the eye. There is geographic variability in the prevalence of organisms. The goal of this study is to investigate region-specific information about common organisms, risk factors, and overall outcomes for EE.
Methods :
Retrospective review of endophthalmitis cases at the University of Minnesota from Jan. 2017 - Jan. 2022. Cases with clinical diagnosis of EE and a positive blood or ocular culture or response to treatment for presumed infection were included. Endophthalmitis associated with ocular surgery, trauma, injection, or bleb were excluded. Outcome measures included change in visual acuity (VA) and rate of surgery. VA was converted to logarithm of minimum angle of resolution (logMAR). Student's t-test was used for statistical analysis.
Results :
Of 164 endophthalmitis cases, 17 cases (21 eyes: 4 OU, 7 OD, 6 OS) were included. History of hypertension (n = 10), hepatobiliary disease (n = 5), and the use of antibiotics 3 months prior to diagnosis of EE (n = 5) were the most common associated factors. Others included history of intravenous drug use (n = 4), diabetes (n = 4), and renal diseases (n = 4). All cases had a blood culture, and 14 cases also had an ocular culture. Out of 12 positive blood cultures, Gram+ cocci (n = 9) were the most common with 6 being S. aureus. 5 out of 15 ocular cultures were positive; Gram+ cocci in 4 cultures. Blood and ocular culture grew the same organism in 4 cases. 5 cases grew Gram+ cocci in blood culture but did not have any growth in ocular culture. 2 cases had polymicrobial growth. 12 eyes required ocular surgery. Excluding 3 eyes with evisceration, final VA was slightly better than 20/200 (mean logMAR 0.97 ± 1.20) and trended towards better than presenting VA (VA 20/320, mean logMAR 1.24 ± 1.04, n = 18, p = 0.08). Eyes that received intravitreal injection (IVI) and surgery had final VA of 20/800 (mean logMAR 1.62 ± 1.21) and did not differ from presenting VA (mean logMAR 1.67 ± 0.98, n = 8, p = 0.44). Eyes that received only IVI improved from around 20/400 (mean logMAR 1.27 ± 0.96) to slightly better than 20/100 (mean logMAR 0.66 ± 1.08, n = 7, p < 0.05).
Conclusions :
Risk factors commonly associated with EE were present in our cohort. Similar to previous studies, Gram+ cocci were the most common associated organisms. Patients who required only IVI trended toward better VA in our cohort.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.