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Acute bilateral postoperative endophthalmitis in a HLA-DQ5-positive patient: possible susceptibility to infections

C L Nicoli1, R D Wainsztein

  • 1Department of Ophthalmology, Oftalmos, Instituto Oftalmologico de Alta Complejidad, University of Buenos Aires, Republica Argentina. nicoli@mbox.servicenet.com.ar

Ophthalmic Surgery and Lasers
|July 28, 2001
PubMed

Insights

This case report suggests a link between HLA-DQ5 and bilateral acute endophthalmitis after cataract surgery. Further research is needed to confirm if this human leukocyte antigen predisposes patients to infection.

Area of Science:

  • Ophthalmology
  • Immunogenetics

Background:

  • Postoperative endophthalmitis is a serious complication following cataract surgery.
  • The role of specific human leukocyte antigen (HLA) types in susceptibility to postoperative infections is not fully understood.

Observation:

  • A 35-year-old woman with high myopia developed bilateral acute endophthalmitis after undergoing phacoemulsification in both eyes.
  • Infection in the right eye was caused by Staphylococcus epidermidis, and the left eye by Propionibacterium acnes.
  • Both infections were successfully treated with intracameral vancomycin.

Findings:

  • The patient was found to be positive for the HLA-DQ5 (DQ1) and DQ2 antigens.
  • This case raises the possibility that HLA-DQ5 may be a predisposing factor for both Staphylococcus and Propionibacterium acnes endophthalmitis.

Implications:

  • A potential association between HLA-DQ5 and increased risk of postoperative endophthalmitis warrants further investigation.
  • A multicenter prospective study is proposed to evaluate HLA antigen presence in patients with a history of fellow eye endophthalmitis.
  • Identifying predisposing genetic factors could lead to personalized prophylactic strategies for high-risk cataract surgery patients.

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