Central Nervous System Involvement in Patients with Endogenous Endophthalmitis: A Retrospective Study

Area of Science:

• Ophthalmology
• Neurology
• Infectious Diseases

Background:

• Endogenous endophthalmitis is a serious intraocular infection.
• While visual acuity effects are known, central nervous system (CNS) complications are less understood.
• This study investigates CNS involvement in endogenous endophthalmitis.

Purpose of the Study:

• To investigate the incidence and types of central nervous system involvement in patients with endogenous endophthalmitis.
• To identify potential risk factors and outcomes associated with CNS complications.

Main Methods:

• Retrospective analysis of hospitalized patients with endogenous endophthalmitis (January 2010 - November 2020).
• Documentation of patient demographics, comorbidities, infection source, and neurological complications.
• Review of available CNS imaging by a neuroradiologist.

Main Results:

• 14 out of 62 patients (23%) experienced at least one CNS complication.
• Common CNS complications included ischemic brain infarction (8 patients), encephalopathy (7 patients), and cerebral hemorrhage (4 patients).
• Culture positivity (blood or intraocular) was observed in most patients with CNS complications (57% positive blood cultures).

Conclusions:

• The incidence of CNS complications in endogenous endophthalmitis may be higher than previously reported.
• No specific risk factors for CNS disease were identified, but culture positivity correlated with more severe CNS involvement.
• Endogenous endophthalmitis poses a significant risk for neurological complications requiring further investigation.