Pseudomonas aeruginosa Endophthalmitis: Clinical Outcomes and Antibiotic Susceptibilities

To report the clinical characteristics, antibiotic susceptibilities, and visual outcomes for eyes with endophthalmitis caused by Pseudomonas aeruginosa.

In this retrospective, non-comparative case series, medical records of eyes with culture-proven Pseudomonas aeruginosa endophthalmitis, who were treated from April 2005 to April 2015 at a referral center in Tehran were reviewed. Clinical features, antibiotic susceptibilities, and visual outcomes were assessed.

In total, 20 eyes of 19 patients were identified. The clinical settings included cataract surgery (85%), pars plana vitrectomy (5%), endogenous source (5%), and intravitreal bevacizumab injection (5%). Presenting visual acuity ranged from 20/120 to no light perception. Pars plana vitrectomy with intravitreal antibiotic injection was performed as the initial treatment in 16 eyes (80%). The organisms were sensitive to ciprofloxacin and imipenem in 100%; amikacin in 88.3%; ceftazidime in 83.4%; and tobramycin in 83.4% of isolates tested. Final visual acuity was hand motions or worse in 18 eyes (90%). Evisceration was performed in five eyes (20%).

Susceptibility to ciprofloxacin and imipenem was found in all isolates tested. Despite appropriate treatment, visual and anatomic outcomes were generally poor.