Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center |
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Authors: | Humeyra Karacal Steven M Kymes Rajendra S Apte |
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Affiliation: | (1) Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Box 8096, St. Louis, MO 63105, USA;(2) Barnes Retina Institute, Washington University School of Medicine, 660 South Euclid Avenue, Box 8096, St. Louis, MO, USA |
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Abstract: | Purpose 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. |
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Keywords: | Endophthalmitis Vitrectomy Retina |
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