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Quantitative Ocular Ultrasound Findings in Microbial Keratitis-Associated Endophthalmitis
Narine Viruni1, Alice Y Zhang1, Xueyang Wang1
1Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, Maryland.
Ophthalmology. Retina
|March 10, 2020
Summary
Ocular ultrasound can detect vitreous opacities in infectious keratitis, aiding in endophthalmitis diagnosis. Increased opacities correlate with higher endophthalmitis likelihood and treatment needs.
Area of Science:
- Ophthalmology
- Medical Imaging
Background:
- Infectious keratitis poses a risk for endophthalmitis, a severe intraocular infection.
- Early diagnosis and management are crucial for preserving vision.
Purpose of the Study:
- To correlate ocular ultrasound findings with clinical parameters in infectious keratitis patients.
- To evaluate the utility of ultrasound in managing suspected endophthalmitis.
Main Methods:
- Retrospective analysis of 73 patients with microbial keratitis undergoing ocular ultrasound.
- Masked grading of ultrasound images for vitreous opacities (percentage of vitreous cavity occupied).
- Comparison of demographic and clinical characteristics between patients with and without endophthalmitis.
Main Results:
- Endophthalmitis occurred in 20.5% of patients; positive intraocular cultures in 26.7% of these cases.
- A significant association was found between increased vitreous opacities (≥50%) and endophthalmitis (OR 3.97, P < 0.0001).
- Endophthalmitis was linked to older age, pseudophakia, and hypopyon height, but not to specific clinical signs like pain or ulcer size.
Conclusions:
- More severe vitreous opacities on ultrasound predict a higher likelihood of endophthalmitis requiring treatment.
- Older, pseudophakic patients with microbial keratitis are more susceptible to severe vitreous opacities.
