Culture-proven endogenous endophthalmitis: ocular and systemic clinical features and outcomes
摘要
To report the clinical presentation, systemic associations, microbiologic spectrum, management strategies, and treatment outcomes of patients with culture-proven endogenous endophthalmitis.
MethodsA retrospective review of medical records was conducted of patients with culture-proven endogenous endophthalmitis between 2013 and 2024. Data collected included demographics, systemic and ocular findings, culture results, imaging studies, management strategies, and treatment outcomes.
ResultsA total of 50 eyes from 41 patients were identified. Of these, 30/41 (73%) presented in an outpatient setting. The most common presenting symptom was blurred vision in 36/41 (88%) with only 16/41 (39%) presenting with systemic symptoms. Vitreous cultures disclosed fungal organisms in 19/41 (46%) of cases and bacterial in the remainder. Blood cultures were positive in 23/41 (56%). A systemic source of infection was identified in 23/41 (56%), most often associated with indwelling medical devices in 7/23 (30%). Intravenous drug use was present in 7/41 (17%). All patients received intravitreal antimicrobials and 25/50 (50%) underwent vitrectomy. Death associated with systemic infection occurred in only 3/41 (7%) of patients. Evisceration was performed in 2/50 (4%) eyes. Visual acuity at last follow up was ≥ 20/400 in 26/50 (52%) of eyes.
ConclusionsEndogenous endophthalmitis was associated with a fungal source in 46% of cases and was not associated with systemic symptoms in 61% of cases. In the current study, indwelling medical devices remain an important source of infection. Despite prompt treatment, visual outcomes were generally poor.