Abstract
Purpose :
The diagnosis of infectious endophthalmitis is generally supported by clinical data and complemented with the ultrasonographic examination. The aim of the present study was to analyze the sensitivity of clinical and ultrasonographic findings of endophthalmitis in the first visit.
Methods :
Retrospective, observational clinical study. Patients with diagnosis of infectious endophthalmitis between January 2018 to July 2022 at the Institute of Ophthalmology Conde de Valenciana in Mexico City were included. Data collected included demographic, clinical, and ultrasonographic data at the initial visit. Major outcome was sensitivity of clinical findings. Patients were grouped into surgery-associated (SA), trauma-associated (TA), and microbial keratitis-associated (MKA). Analysis of variance, t-test, and Fisher’s exact test for statistical analysis were used.
Results :
Forty-eight patients were included. Mean age was 58.58 ±19.37 years, patients in MKA and SA groups were older than those in the TA group (p<0.05). There was a statistically significant higher proportion of male patients with endophthalmitis in our sample. The most sensitive clinical variables for endophthalmitis detection in the initial visit were loss of fundus view (97.9%), eye redness (93.8%), ocular pain (91.7%), and severe visual impairment (85.4%). The most sensitive ultrasonographic variables were vitreous cellularity (95.8%), retinochoroidal thickness >1.4 mm (66.7%), and vitreous membranes (66.6%). All the patients in the TA group presented with severe vision impairment and ocular pain. Fundus evaluation was impaired in all patients in the MKA group. Patients in the SA group had better initial best-corrected visual acuity (BCVA). There was no significant difference in the final BCVA between groups.
Conclusions :
In infectious endophthalmitis an early diagnosis is critical to optimize the visual outcome. The sensitivity of these clinical and ultrasonographic variables can help in the initial diagnostic evaluation of patients with endophthalmitis in our environment.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.