Clinical Characteristics and Prognosis of Endogenous Endophthalmitis in Western Gyeongsangnam-do

Ji-Seong Jeong; Min Ho Shin; Jin Seok Seo; Woong-Sun Yoo; Jong Moon Park; In Young Chung

doi:10.3341/jkos.2019.60.9.851

Journal List > J Korean Ophthalmol Soc > v.60(9) > 1133115

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Jeong, Shin, Seo, Yoo, Park, and Chung: Clinical Characteristics and Prognosis of Endogenous Endophthalmitis in Western Gyeongsangnam-do

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(9): 851-858.

Published online: 18 September 2019

DOI: https://doi.org/10.3341/jkos.2019.60.9.851

Clinical Characteristics and Prognosis of Endogenous Endophthalmitis in Western Gyeongsangnam-do

Ji-Seong Jeong, MD¹, Min Ho Shin, MD², Jin Seok Seo, MD¹, Woong-Sun Yoo, MD¹, Jong Moon Park, MD, PhD^1,³, In Young Chung, MD, PhD^1,³

¹Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea.

²Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea.

³Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.

Address reprint requests to In Young Chung, MD, PhDDepartment of Ophthalmology, Gyeongsang National University Hospital, #79 Gangnam-ro, Jinju 52727, Korea. Tel: 82-55-750-8171, Fax: 82-55-758-4158, in0chung@hanmail.net

Received 3 January 2019 Revised 7 February 2019 Accepted 16 August 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the clinical features and prognosis associated with endogenous endophthalmitis (EE) in western Gyeongsangnam-do over an 11-year period.

Methods

This study was a retrospective review of the medical records of 24 patients (33 eyes) who presented with endogenous endophthalmitis at the Gyeongsang National University Hospital from 2007 to 2017.

Results

The mean age of onset was 63.2 years, and 58.3% of the patients were men. Bilateral involvement was observed in nine patients (37.5%). Liver abscess (30.3%) and urinary tract infection (24.2%) were the most common extraocular sources of infection. Positive culture result was noted in 72.7% of the patients. The most common causative agents were gram-negative organisms (45.8%); the most commonly isolated microorganism was Klebsiella pneumoniae. Vitreous tapping and intravitreal antibiotic injection were performed in all patients; pars plana vitrectomy with intravitreal injection of antibiotics was performed in 12 eyes (36.4%). Enucleation and evisceration were performed in six eyes (18.2%). Initial visual acuity worse than hand motion was associated with a significantly worse visual outcome (p = 0.001).

Conclusions

In our study, EE showed a poor visual prognosis, irrespective of treatment. Poor initial visual acuity was predictive of poor visual outcome. Liver abscess and urinary tract infections were common extraocular sources of EE and K. pneumoniae was the most common causative organism.

Keywords: Endophthalmitis, Klebsiella, Prognosis, Liver abscess

Figures and Tables

Figure 1

Identifiable associated systemic factors of patients with endogenous endophthalmitis. Diabetes is the leading systemic factor following cancer, chronic kidney disease and liver cirrhosis.

Figure 2

Identifiable presumed infection source of patients with endogenous endophthalmitis. Note that liver abscess is the leading cause of presumed infection source.

Table 1

Demographics of 24 patients with endogenous endophthalmitis

Values are presented as mean ± standard deviation (range) or number (%).

M/F = male/female; BCVA = best-corrected visual acuity; logMAR= the logarithm of the minimal angle of resolution; PPV = pars planar vitrectomy.

Table 2

Microbial isolates from blood, aqueous and vitreous samples of patients with endogenous endophthalmitis (n = 33)

Values are presented as number (%).

CNS = coagulase negative staphylococcus.

Table 3

Prognostic factors associated with poor visual outcome

Values are presented as number (range).

OR = odds ratio; sx. = symptom; VA = visual acuity; CF, counting finger.

^*Adjusted odds ratio by firth logistic regression; ^†treatment means intravitreal antibiotics injection +/− pars plana vitrectomy.

Table 4

Reported studies of endogenous endophthalmitis in a Korean population

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

Appendices

Appendix 1

The clinical summary of patients with endogenous endophthalmitis.

Appendix 2

Treatment and visual outcomes of patients with endogenous endophthalmitis.

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