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

Abstract EN

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.