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A Prospective Study on the Clinical and Microbiological Spectrum of Endophthalmitis in a Specific Region in Denmark.

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  • Author(s): Solborg Bjerrum S;Solborg Bjerrum S; Hamoudi H; Friis-Møller A; la Cour M
  • Source:
    Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde [Ophthalmologica] 2016; Vol. 235 (1), pp. 26-33. Date of Electronic Publication: 2015 Dec 04.
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Karger Country of Publication: Switzerland NLM ID: 0054655 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1423-0267 (Electronic) Linking ISSN: 00303755 NLM ISO Abbreviation: Ophthalmologica Subsets: MEDLINE
    • Publication Information:
      Publication: Basel : Karger
      Original Publication: Basel.
    • Subject Terms:
      Bacteria/*isolation & purification ; Endophthalmitis/*microbiology ; Eye Infections, Bacterial/*microbiology; Aged ; Aged, 80 and over ; Cataract Extraction/adverse effects ; Denmark/epidemiology ; Endophthalmitis/epidemiology ; Eye Infections, Bacterial/epidemiology ; Female ; Humans ; Intravitreal Injections/adverse effects ; Male ; Postoperative Complications ; Prospective Studies
    • Abstract:
      Purpose: To study the clinical and microbiological spectrum of endophthalmitis with emphasis on clinical features, visual outcomes and risks of surgical complications.
      Methods: A prospective observational study was conducted between 2012 and 2013 in a specific region in Denmark. Patients were clinically examined before, during and after surgical intervention for endophthalmitis.
      Results: Fifty eyes with endophthalmitis were included. Endophthalmitis after cataract surgery (post-cataract), anti-VEGF (vascular endothelial growth factor) intravitreal injections (post-injection) and cases of endogenous endophthalmitis were responsible for 40, 28 and 18% of all cases, respectively. There was no difference in the microbiological spectrum in post-cataract patients and post-injection patients, but patients with post-cataract endophthalmitis presented statistically significantly more frequently with hypopyon and fibrin in the anterior chamber. Between 20 and 25% of post-cataract and post-injection endophthalmitis patients developed a surgical complication after primary surgical intervention for endophthalmitis, and this was statistically significantly associated with a poor visual outcome. There was no statistically significant difference in the risk of surgical complications in phakic and pseudophakic eyes with post-injection endophthalmitis. Of the 8 patients with endogenous endophthalmitis, 67% developed a surgical complication, and these patients had a high mortality. The visual outcome in the most common types of endophthalmitis was good, with 60% of post-cataract patients achieving a visual outcome ≥ 0.5, and 64% of post-injection patients only had a mild vision loss (1-14 ETDRS letters) or even gained vision.
      Conclusions: The endophthalmitis cases had a broad clinical spectrum. Surprisingly, endogenous endophthalmitis accounted for almost one fifth of all cases. Patients with post-cataract endophthalmitis had a clinically different presentation than patients with post-injection endophthalmitis. In general, the bacteria were low-virulent and the visual outcomes good, but a substantial part of the patients developed a surgical complication which was associated with a poor visual outcome.
      (© 2015 S. Karger AG, Basel.)
    • Publication Date:
      Date Created: 20151204 Date Completed: 20161114 Latest Revision: 20161230
    • Publication Date:
      20250114
    • Accession Number:
      10.1159/000441662
    • Accession Number:
      26633803