TY - JOUR
T1 - Culture-proven endogenous endophthalmitis
T2 - Clinical features and visual acuity outcomes
AU - Schiedler, Vivian
AU - Scott, Ingrid U.
AU - Flynn, Harry W.
AU - Davis, Janet L.
AU - Benz, Matthew S.
AU - Miller, Darlene
N1 - Funding Information:
Supported in part by Research to Prevent Blindness, Inc., New York, New York.
PY - 2004/4
Y1 - 2004/4
N2 - Purpose To investigate clinical features and visual acuity outcomes associated with endogenous endophthalmitis. Design Retrospective, observational case series. Methods Twenty-one eyes of 21 patients treated at Bascom Palmer Eye Institute for culture-proven endogenous endophthalmitis between 1996 and 2002 were reviewed. Results Patients were followed a mean of 3 months (range, 1 to 12 months). Fungal isolates occurred in 13 eyes (62%), gram-positive isolates in 7 (33%), and gram-negative isolates in 1 (5%). Twelve patients (57%) were hospitalized at the time of diagnosis and 6 patients (29%) died within 2 months of diagnosis. Initial treatment included tap and injection of intravitreal medication in 10 eyes (48%) and pars plana vitrectomy with injection of intravitreal medication in 11 eyes (52%). Final visual outcomes were obtainable for 18 eyes (two patients died within 10 days of diagnosis, and one patient was lost to follow-up). Eight (44%) of these 18 eyes achieved a visual acuity of 20/400 or better and 10 (56%) of 18 eyes achieved a visual acuity worse than 20/400, including 3 that were either enucleated or eviscerated. Three eyes with Aspergillus endophthalmitis had worse visual outcomes than eyes with either Candida (P = .036) or bacterial endophthalmitis (P = .024). Conclusions Compared with published series of postoperative or post-traumatic endophthalmitis, patients with endogenous endophthalmitis are more likely to have fungal isolates with a predominance of Candida albicans. Endogenous endophthalmitis is generally associated with high mortality and poor visual acuity outcomes, particularly when caused by more virulent species such as Aspergillus.
AB - Purpose To investigate clinical features and visual acuity outcomes associated with endogenous endophthalmitis. Design Retrospective, observational case series. Methods Twenty-one eyes of 21 patients treated at Bascom Palmer Eye Institute for culture-proven endogenous endophthalmitis between 1996 and 2002 were reviewed. Results Patients were followed a mean of 3 months (range, 1 to 12 months). Fungal isolates occurred in 13 eyes (62%), gram-positive isolates in 7 (33%), and gram-negative isolates in 1 (5%). Twelve patients (57%) were hospitalized at the time of diagnosis and 6 patients (29%) died within 2 months of diagnosis. Initial treatment included tap and injection of intravitreal medication in 10 eyes (48%) and pars plana vitrectomy with injection of intravitreal medication in 11 eyes (52%). Final visual outcomes were obtainable for 18 eyes (two patients died within 10 days of diagnosis, and one patient was lost to follow-up). Eight (44%) of these 18 eyes achieved a visual acuity of 20/400 or better and 10 (56%) of 18 eyes achieved a visual acuity worse than 20/400, including 3 that were either enucleated or eviscerated. Three eyes with Aspergillus endophthalmitis had worse visual outcomes than eyes with either Candida (P = .036) or bacterial endophthalmitis (P = .024). Conclusions Compared with published series of postoperative or post-traumatic endophthalmitis, patients with endogenous endophthalmitis are more likely to have fungal isolates with a predominance of Candida albicans. Endogenous endophthalmitis is generally associated with high mortality and poor visual acuity outcomes, particularly when caused by more virulent species such as Aspergillus.
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U2 - 10.1016/j.ajo.2003.11.013
DO - 10.1016/j.ajo.2003.11.013
M3 - Article
C2 - 15059712
AN - SCOPUS:1842608801
SN - 0002-9394
VL - 137
SP - 725
EP - 731
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 4
ER -