Metastatic endophthalmitis: a reappraisal

In view of the lack of studies of metastatic endophthalmitis and the controversies surrounding its management, we did a retrospective study of ten cases of metastatic endophthalmitis admitted to our center in 1987. A disproportionately high incidence of pediatric patients was found. The etiologic diagnosis was possible in eight of the ten cases. Bacterial infection was responsible in five of the eight cases where positive cultures were grown. Pseudomonas aeruginosa was the most common bacterial pathogen isolated. Most of the cases responded poorly to medical management. Seven of the ten patients finally underwent vitrectomy. Four of these seven cases had a postoperative visual acuity equal to or greater than 6/60 after vitrectomy. We believe that pars plana vitrectomy has a definite role in the management of metastatic endophthalmitis.