Incidence and outcome of endophthalmitis over a 13-year period.
OBJECTIVE
The aim of the study was to assess the functional results and long-term visual prognosis in patients treated for acute endophthalmitis (AE).


METHODS
Observational clinical series.


METHODS
Evaluation of 120 eyes of 114 patients with AE treated between 1991 and 2004.


METHODS
This retrospective institutional analysis included 120 eyes of 114 patients (52 male, 68 female) with AE and a minimum follow-up of half a year. The patients had a mean follow-up of 23 months (6-135 months) and a mean age of 61 years (8 months-94 years) at the time of treatment. Treatment included intraocular injection of antibiotics alone (n = 18, 15%) and vitrectomy combined with intraocular and topical postoperative antibiotics (n = 85, 70%).


RESULTS
The most frequent complications were vitreous or retinal hemorrhages (n = 17, 14%), retinal detachment (n = 17, 14%), choroidal detachment (n = 3, 3%), secondary glaucoma (n = 7, 6%), and recurrent endophthalmitis (n = 3, 3%). Four eyes had to be enucleated because of recurrent and uncontrollable infection. Positive microbiological results were achieved in 67 of 88 specimens (76%). The most common isolate was Staphylococcus. At the end of follow-up, visual acuity was reduced (more than 2 lines) in 18 eyes (15%), stable in 22 (18%), and improved (more than 2 lines) in 72 eyes (60%).


CONCLUSIONS
AE is a rare but severe disease with a potentially deleterious outcome in affected eyes. In our series, 78% of all eyes had stable or improved postoperative visual acuity following various treatment regimens, depending on the severity of each case.
Krause
Lothar
L
Department of Ophthalmology, Charité-Universitätsmedizin Berlin, Berlin, Germany. lothar.krause@charite.de
Bechrakis
Nikolaos E
NE
Heimann
Heinrich
H
Kildal
Daniela
D
Foerster
Michael H
MH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D009877:Endophthalmitis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy*; D004739:England / Q000453:epidemiology; D015817:Eye Infections / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult
D000900:Anti-Bacterial Agents