Details

Autor(en) / Beteiligte

• Mathews, Namita
• Barry, Robery J.
• Butt, Gibran F.

Titel

Review of endogenous endophthalmitis in a tertiary eye centre; can we spot the trends?

Ist Teil von

• Acta ophthalmologica (Oxford, England), 2019-12, Vol.97 (S263), p.n/a

Ort / Verlag

Malden: Wiley Subscription Services, Inc

Erscheinungsjahr

2019

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Purpose Endogenous endophthalmitis is a rare but sight‐threatening infection due to haematogenous spread of pathogens. Early diagnosis and appropriate treatment reduces morbidity. This study aimed to identify pathogenic similarities and visual outcomes. Method A retrospective audit of all endogenous endophthalmitis cases between January 2010 and December 2016 at the Birmingham and Midlands Eye Centre (BMEC) was undertaken. All patients coded as having a diagnosis of endophthalmitis in the electronic patient records system, were identified and the case notes reviewed. Details of each case (microbiology, source of infection and outcome) were recorded. Cross‐tabulations were performed to identify trends and prognostic factors. Results Ten males and six females (range 38–96 years) were identified. This constituted 6% of all endophthalmitis cases at BMEC in the study period. Eyes affected: six left, four bilateral and six right. Twelve cases (75%) had identifiable risk factors (e.g. bacterial endocarditis, malignancy, immunodeficiency). Seven (44%) cases were culture positive from vitreous or aqueous samples: four bacterial and three fungal. Initial broad‐spectrum therapy covered for six of these of these cases (86%) from sensitivity data. Six patients were found to be culture positive from a non‐ocular sample. A source of infection was identified in 13 patients (76%). After treatment, four patients (25%) achieved driving‐standard vision or better, eight patients (50%) had no perception of light, of whom 3 (38%) underwent evisceration. Conclusion Patients with risk factors and clinical suspicion of endogenous endophthalmitis should be reviewed and treated promptly. Our results demonstrate that less than half of cases are culture positive from vitrectomy samples therefore it is important to assess thoroughly for the source and send all available ocular and non‐ocular microbiology samples. Visual outcome remains poor for this condition and patients should be forewarned of the prognosis.