Bleb-associated endophthalmitis in a Chinese population (2003-2010): clinical characteristics and visual outcome

To analyze the clinical characteristics and treatment outcomes of patients with bleb-associated endophthalmitis (BAE) in a Chinese population.

A retrospective review of patients treated for BAE between January 2003 and December 2010 in a single institution was performed. Data on visual acuity (VA), clinical characteristics, causative organisms, and treatment outcomes were collected and analyzed.

Thirty-one eyes from 31 patients with BAE were identified during the study period. Primary open-angle glaucoma was the most common type of glaucoma in this series (18 eyes, 58.1%). The time between glaucoma filtering surgery and diagnosis of endophthalmitis ranged from 18 days to 32 years, with a mean of 6.95 ± 8.22 years. Nine eyes (32.1%) were culture positive, and the most common organisms identified were Staphylococcus species (6/9, 66.7%). Best-corrected VA at 12 months after treatment ranged from 20/30 to no light perception (NLP). Twelve (38.7%) eyes achieved VA of 20/400 or better, and 7 (22.6%) eyes had NLP. In patients undergoing initial tap-and-inject treatment, the eyes with presenting VA of finger count or better were associated with a higher treatment success rate (87.5%) than those of hand movement (33.3%) or light perception or NLP (9.1%).

Primary open-angle glaucoma was the most common type of glaucoma, and Staphylococcus species was the most common causative organism in this case series of BAE. Despite prompt treatment with appropriate intravitreal antibiotics, BAE still carries a poor visual prognosis.