Endogenous endophthalmitis complicating infective endocarditis: a multicentre case-matched control cohort

Area of Science:

• Ophthalmology
• Infectious Diseases
• Cardiology

Background:

• Endogenous endophthalmitis (EE) is an uncommon but severe intraocular infection.
• Infective endocarditis (IE) is a known, albeit rare, cause of EE.
• Understanding the characteristics of IE-related EE is vital for timely diagnosis and treatment.

Purpose of the Study:

• To investigate the clinical and microbiological features of patients with EE secondary to IE.
• To determine the treatment strategies and outcomes for IE-related EE.
• To compare patients with IE-related EE to a matched control group.

Main Methods:

• An international retrospective case series was conducted from 2014 to 2023.
• Data from nine centers in Europe and the United States were collected.
• Patients with IE-related EE were compared to a matched control group.

Main Results:

• Sixty-six patients with IE-related EE were identified, predominantly male (71%) with a mean age of 65.2 years.
• Streptococci were the most common pathogens (46%), with EE patients showing higher rates of diabetes, cirrhosis, glomerulonephritis, and embolism.
• Ocular symptoms included decreased visual acuity (96%), red eye (55%), and pain (55%); 83% received intravitreal antibiotics, and 55% experienced visual acuity improvement.

Conclusions:

• Endogenous endophthalmitis is a significant complication of infective endocarditis, often leading to severe vision impairment.
• Patients with IE require thorough ocular evaluation to identify EE early.
• Prompt diagnosis and management of EE are essential for preserving visual function in IE patients.