Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center.
OBJECTIVE
To report a large, consecutive series of endophthalmitis of all causes managed at a tertiary referral retina center.


METHODS
Retrospective chart review of all cases diagnosed with endophthalmitis that received reatment and follow-up between January 2000 and January 2005.


RESULTS
A total of 67 patients were diagnosed with endophthalmitis. The most common cause was postoperative endopthalmitis after cataract surgery. Initial management was vitreous needle biopsy with intravitreal antimicrobial injection in a majority of cases (79%). Vitreous cultures were positive in 32 eyes (44.4%); the most common isolate was coagulase negative Staphylococci. Final visual acuity was improved in 61% of patients. More than a third (38%) had vision worse than count fingers. Twenty-eight eyes (39%) needed pars plana vitrectomy for secondary complications as a consequence of endophthalmitis.


CONCLUSIONS
Cataract surgery remains the most common cause of endophthalmitis in this large tertiary referral retina center. Endophthalmitis resolved with vitreous needle biopsy and intravitreal injections in more than half of the cases. However, more than a third of patients required additional vitreoretinal surgery for secondary complications. More than a third of patients had nonfunctional vision after the resolution of endophthalmitis, which highlights the severity of this condition in the current expanding era of office-based intravitreal pharmacotherapy for retinal diseases.
Karacal
Humeyra
H
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Box 8096, St. Louis, MO 63105, USA.
Kymes
Steven M
SM
Apte
Rajendra S
RS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000209:etiology* / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000209:etiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007267:Injections; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology* / Q000628:therapy; D013997:Time Factors; D014821:Vitrectomy; D014822:Vitreous Body
D000900:Anti-Bacterial Agents