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

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

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.

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.

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Figure 2

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

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Table 1

Demographics of 24 patients with endogenous endophthalmitis

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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)

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Values are presented as number (%).

CNS = coagulase negative staphylococcus.

Table 3

Prognostic factors associated with poor visual outcome

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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

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Notes

Conflicts of Interest The authors have no conflicts to disclose.

Appendices

Appendix 1

The clinical summary of patients with endogenous endophthalmitis.

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Appendix 2

Treatment and visual outcomes of patients with endogenous endophthalmitis.

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