title: Current Perspectives of Prophylaxis and Management of Acute Infective Endophthalmitis.
abstract: Endophthalmitis is an intraocular inflammatory condition which may or may not be caused by infective agents. Noninfectious (sterile) endophthalmitis may be attributable to various causes including postoperative retained soft lens matter or toxicity following introduction of other agents into the eye. Infectious endophthalmitis is further subdivided into endogenous and exogenous. In endogenous endophthalmitis there is hematogenous spread of organisms from a distant source of infection whereas in exogenous endophthalmitis direct microbial inoculation may occur usually following ocular surgery or penetrating eye injury with or without intraocular foreign bodies. Acute infective endophthalmitis is usually exogenous induced by inoculation of pathogens following ocular surgery, open-globe injury and intravitreal injections. More infrequently the infective source is internal and septicemia spreads to the eye resulting in endogenous endophthalmitis. Several risk factors have been implicated including immunosuppression, ocular surface abnormalities, poor surgical wound construction, complicated cataract surgery with vitreous loss and certain types of intraocular lens. Comprehensive guidelines and recommendations on prophylaxis and monitoring of surgical cases have been proposed to minimize the risk of acute endophthalmitis. Early diagnosis and prompt management of infective endophthalmitis employing appropriately selected intravitreal antibiotics are essential to optimize visual outcome.
authors.affiliation: Ophthalmica Eye Institute, Thessaloniki, Greece.
authors.forename: Paris
authors.initials: P
authors.lastname: Tranos
authors.affiliation: Ophthalmica Eye Institute, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Dervenis
authors.affiliation: Ophthalmica Eye Institute, Thessaloniki, Greece.
authors.forename: Athanasios N
authors.initials: AN
authors.lastname: Vakalis
authors.affiliation: Ophthalmica Eye Institute, Thessaloniki, Greece.
authors.forename: Solon
authors.initials: S
authors.lastname: Asteriadis
authors.affiliation: 2nd Department of Ophthalmology, University of Athens Medical School, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Stavrakas
authors.affiliation: 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece. konstas@med.auth.gr.
authors.forename: Anastasios G P
authors.initials: AG
authors.lastname: Konstas
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D019468:Disease Management; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D006801:Humans; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cataract; Endophthalmitis; Infection; Intravitreal antibiotics; Ophthalmology; Uveiti; Vitrectomy