Transvitreal fibrinoid pseudoendophthalmitis after diabetic vitrectomy

To describe the presentation and clinical course of noninfectious transvitreal fibrinoid response after vitrectomy for diabetic retinopathy.

Data collected from charts included age, gender, surgical indication, preoperative and serial visual acuities, vitrectomy procedures, and postoperative clinical characteristics of involved eye.

Patients had a mean age of 65.6 years (51-82 years) with 5 women and 2 men. Patients had a range of diabetes duration from 4 to 27 years and a mean HgbA1C of 9.1 (5.8-14.1). Surgical indications included nonclearing vitreous hemorrhage (five), tractional retinal detachment (three), and clinically significant macular edema (one). All patients manifested transvitreal bands on postoperative Day 1 without anterior chamber reaction. Mean time to resolution of transvitreal bands was 8.75 days (4-15 days) on standard postoperative topical medications alone.

Transvitreal fibrinoid response after diabetic vitrectomy is a remarkable phenomenon that can occur in a wide variety of patients with diabetic retinopathy. It is important to differentiate this from infectious endophthalmitis, as this series of cases resolved spontaneously on topical medications alone.