Endogenous Endophthalmitis: A 10-Year Retrospective Study at a Tertiary Hospital in South India

Asia Pac J Ophthalmol (Phila). 2015 Sep-Oct;4(5):286-92. doi: 10.1097/APO.0000000000000120.

Abstract

Purpose: The aim of this study was to review the clinical profile including predisposing systemic conditions, microorganisms responsible, clinical presentation, and outcomes of endogenous endophthalmitis (EE) in South India.

Design: This study is a retrospective, noncomparative case series.

Methods: This study presents a retrospective analysis of records of patients with EE in a 10-year period.

Results: A total of 61 eyes of 58 patients were included in the study. Preceding systemic illness or surgery was noted in 31 patients (53.4%). No predisposing condition was found in 27 patients (46.5%). All eyes had severe diffuse EE. Culture positivity was seen in 34 of 58 patients (58.6%). Gram-positive organisms were isolated in 9 cases (15.5%), and Gram-negative organisms were isolated in 20 cases (34.5%). Pseudomonas aeruginosa (13.8%) was the most common isolate. Eleven eyes (18%) were managed medically with intravenous and intravitreal antibiotics, and 38 eyes (62.3%) also underwent vitrectomy. Eight eyes (13.1%) required repeat vitrectomy, and 12 eyes (19.7%) were eviscerated. The mean follow-up was 16.2 ± 13.9 months. Final visual acuity of 20/200 or better was seen in 29.5% eyes. A favorable outcome was noted in culture-positive patients (P = 0.03) and in patients with no predisposing causes.

Conclusions: This study provides information about the clinical and microbiologic profile of EE. Aggressive medical and surgical treatment can result in favorable outcomes.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Aqueous Humor / microbiology
  • Bacteremia / diagnosis
  • Bacteremia / microbiology*
  • Bacteremia / therapy
  • Bacteria / isolation & purification
  • Combined Modality Therapy
  • Endophthalmitis / diagnosis
  • Endophthalmitis / microbiology*
  • Endophthalmitis / therapy
  • Eye Evisceration
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / microbiology*
  • Eye Infections, Bacterial / therapy
  • Female
  • Humans
  • India
  • Injections, Intravenous
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers
  • Visual Acuity / physiology
  • Vitrectomy
  • Vitreous Body / microbiology

Substances

  • Anti-Bacterial Agents