A 14-Year Retrospective Analysis of Endogenous Endophthalmitis in a Tertiary Referral Center of Southern Thailand

Author:

Bhurayanontachai Patama1ORCID,Klongthanakit Phingphan1ORCID

Affiliation:

1. Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, 15 Karnjanawanich Road, Hat Yai, Songkhla 90110, Thailand

Abstract

Purpose. To investigate patient characteristics, clinical features, common causative organisms, and visual acuity outcomes in endogenous endophthalmitis. Methods. This was a retrospective chart analysis of patients with endogenous endophthalmitis between January 2006 and December 2019. Collected data included basic patient characteristics, presenting symptoms, causative organisms, treatments, and 3-month and 1-year visual outcomes. Results. Twenty-nine eyes of 27 patients were included in the study. The mean age of the patients was 45.4 ± 19.9 years, and 63% were female. Visual acuity at presentation ranged from counting fingers to no light perception. Systemic comorbidities presented in 66.7% of the patients, the majority of which were related to diabetes mellitus (48.1%). The most common primary infection was a urinary tract infection. Positive blood cultures were identified in 48.1% of patients, and positive cultures from vitreous and aqueous samples were identified in 59.3% and 31.6% of eyes, respectively. Among all the specimens, Gram-positive bacteria were identified in 55.5%, Gram-negative bacteria in 22.2%, fungi in 14.8%, and mixed organisms in 7.4%. Among ocular specimens, 61.1% contained Gram-positive organisms, 16.7% contained Gram-negative organisms, and 22.2% contained fungi. Streptococcus spp. was the most common causative organism. From 29 eyes, 18 (62.1%) underwent vitrectomy, and 12 (42.9%) underwent either evisceration or enucleation. Positive vitreous culture was significantly associated with unfavorable final visual outcome. Final visual acuity ranged from 20/125 to no light perception. Although visual improvement at 3 months was significantly better in younger patients, this had no impact on final visual outcome at 1 year. Conclusion. Eyes with positive vitreous cultures had significantly poorer visual outcomes. Despite full treatment coverage, visual prognosis was extremely poor and the rates of blindness and evisceration/enucleation were still high.

Funder

Faculty of Medicine, Prince of Songkla University

Publisher

Hindawi Limited

Subject

Ophthalmology

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