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Published on: February 6, 2021
Endogenous endophthalmitis: 10-year experience at a tertiary referral centre
P P Connell1, E C O'Neill, D Fabinyi
1Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, VIC, Australia. drpaulconnell@gmail.com
Eye (London, England)
|October 23, 2010
Summary
Endogenous endophthalmitis (EE) is a severe eye condition with varied causes. Management outcomes are often poor, though fungal cases show better prognosis and bacterial cases benefit from vitrectomy.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Endogenous endophthalmitis (EE) is a critical ocular emergency with multifactorial causes.
- Delayed diagnosis of EE can lead to significantly poorer visual prognosis.
- This study details the management and visual outcomes of EE at a tertiary referral center.
Purpose of the Study:
- To describe the management strategies and visual outcomes for patients with endogenous endophthalmitis (EE).
- To analyze the etiological factors, microbial profiles, and treatment responses in EE cases.
- To evaluate the impact of different management approaches, including vitrectomy, on visual acuity in EE.
Main Methods:
- A prospective, consecutive case series of 64 patients with presumed EE was conducted from 1997 to 2007.
- Data collected included presenting and final visual acuity, microbial profiles, and vitrectomy rates.
- Standardized data collection methods were employed at the Royal Victorian Eye and Ear Hospital.
Main Results:
- The study identified 64 EE cases, with a mean age of 57.5 years; 53.5% were male.
- Intravenous drug abuse was a significant risk factor (78.1%).
- Culture positivity was 64.1%. Vitrectomy rates were 57% (bacterial), 56% (fungal), and 21% (no growth). Fungal cases showed better visual outcomes, while 5 eyes required enucleation, 3 due to Klebsiella.
Conclusions:
- Endogenous endophthalmitis (EE) is a serious condition with diverse etiologies and often poor visual outcomes.
- Fungal EE generally confers a better prognosis compared to bacterial EE.
- Vitrectomy is recommended for bacterial EE cases to improve visual prognosis.
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