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Visual Acuity Influences Visual Outcome in Endophthalmitis: A 10-Year Retrospective Observational Cohort Analysis
Yvonne Nowosielski1, Charlotte Erlacher2, Sarah Maier3
1Department of Ophthalmology and Optometry, Medical University of Innsbruck, Innsbruck, Austria. yvonne.nowosielski@i-med.ac.at.
Ophthalmology and Therapy
|August 13, 2026
Summary
Delayed surgery for exogenous endophthalmitis increases re-intervention rates. Early intervention with tap-and-inject may improve outcomes for these sight-threatening infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Surgical Outcomes
Background:
- Endophthalmitis is a severe intraocular infection following ophthalmic procedures or endogenous spread.
- Treatment strategies have evolved since the Endophthalmitis Vitrectomy Study (EVS) in 1995.
Purpose of the Study:
- Evaluate current treatment approaches for endophthalmitis.
- Analyze microbial spectrum and patient outcomes over a decade.
- Identify predictors of visual outcome and re-intervention.
Main Methods:
- Retrospective observational cohort analysis (2013-2023) of 118 eyes from 110 patients.
- Categorization into exogenous, endogenous, or keratitis-related endophthalmitis.
- Assessment of etiology, treatment (tap-and-inject, PPV, delayed surgery), time to intervention, microbial isolates, and visual acuity (BCVA).
Main Results:
- Exogenous cases (60.2%) and endogenous cases (28.8%) were analyzed.
- Median BCVA improved from 2.3 to 1.0 logMAR at 6 months.
- Delayed surgery in exogenous endophthalmitis significantly increased re-intervention rates (HR 5.7, p<0.001).
Conclusions:
- Visual acuity at diagnosis is a key prognostic factor for recovery.
- Delayed surgery in exogenous endophthalmitis is linked to high re-intervention rates.
- Initial tap-and-inject treatment may reduce re-interventions; further prospective studies are warranted.
