POSTTRAUMATIC ENDOPHTHALMITIS: An 18-Year Case Series

Retina. 2018 Jan;38(1):60-71. doi: 10.1097/IAE.0000000000001511.

Abstract

Purpose: To describe the demographics, characteristics, management, and visual outcomes of eyes diagnosed with endophthalmitis after open globe injury.

Methods: Retrospective cohort analysis of all patients diagnosed with endophthalmitis after open globe injury from 1997 to 2015 at University Hospital, Newark, NJ.

Results: Twenty-six eyes were identified (all male patients; mean age: 37 ± 15 years). Cultures were positive in 16 eyes (62%), with Staphylococcus species (7 eyes, 44%) being the most common organism. Twelve eyes (46%) presented with open globe injury and concurrent endophthalmitis; 14 eyes (54%) developed endophthalmitis a mean of 14 days after open globe repair (OGR; 1 outlier of 98 days excluded). All eyes were managed with systemic and intravitreal antibiotics. The presence of intraocular foreign body (P < 0.05) and delayed primary OGR (P < 0.03) were significantly more common with concurrent versus post-OGR endophthalmitis. Four (29%) eyes in the post-OGR endophthalmitis group had corneal wound leak after OGR. Four (15%) eyes with no light perception vision were enucleated. Ten (40%) of 25 eyes with documented best-corrected visual acuity had final best-corrected visual acuity ≥20/200; final best-corrected visual acuity ranged from no light perception to 20/20.

Conclusion: The presence of intraocular foreign body and delayed presentation were significantly more common with concurrent endophthalmitis. Twenty-nine percent of eyes that presented with endophthalmitis after OGR had a wound leak. Final best-corrected visual acuity ≥20/200 was achieved in 40% of cases.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Endophthalmitis / diagnosis
  • Endophthalmitis / etiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / etiology*
  • Eye Injuries, Penetrating / complications*
  • Eye Injuries, Penetrating / diagnosis
  • Follow-Up Studies
  • Forecasting*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Visual Acuity
  • Young Adult