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Persistent endophthalmitis after intravitreal antimicrobial therapy
A Shaarawy1, M G Grand, T A Meredith
1Department of Ophthalmology, University of Alexandria School of Medicine, Egypt.
Ophthalmology
|March 1, 1995
Summary
Persistent infection after intravitreal antimicrobial injections for endophthalmitis is common. Repeat antimicrobial injections may be necessary for better visual outcomes in persistent bacterial or fungal infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Endophthalmitis is a serious intraocular infection.
- Intravitreal antimicrobial injections are a primary treatment modality.
Purpose of the Study:
- To determine the frequency of persistent infection after intravitreal antimicrobial therapy for endophthalmitis.
- To evaluate the impact of persistent infection on final visual acuity.
Main Methods:
- Conducted a study on 42 eyes with culture-positive endophthalmitis.
- Performed repeat vitreous cultures and antimicrobial injections in 22 eyes.
- Obtained repeat cultures 3-8 days post-initial therapy in 20 eyes.
Main Results:
- Twelve of 22 eyes (54.5%) remained culture-positive after initial treatment.
- Common organisms in persistent infections included staphylococci, streptococci, Serratia, Propionibacterium acnes, and fungi.
- Eyes with persistent bacterial infection had poorer visual outcomes compared to culture-negative eyes.
- Only 4 of 12 culture-positive eyes achieved visual acuity of 20/200 or better after repeat injection.
Conclusions:
- A single intravitreal antimicrobial injection may not be sufficient for all endophthalmitis cases.
- Consideration of a second antimicrobial injection is warranted for persistent infections.