Document Detail


Endophthalmitis following intravitreal injection versus endophthalmitis following cataract surgery: clinical features, causative organisms and post-treatment outcomes.
MedLine Citation:
PMID:  22446145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To describe and compare the causative organisms, clinical features and visual outcomes of endophthalmitis following intravitreal injection (IVI) to endophthalmitis following cataract surgery.
METHODS: Patient population and setting: A retrospective case series of patients with acute endophthalmitis following either cataract surgery or IVI presenting to a tertiary referral centre--Sydney Eye Hospital--between 2007 and 2010. Main outcome measures: (1) identification of the causative organism; (2) time to presentation; (3) odds of improvement in visual acuity (VA) following treatment; (4) odds of final VA of counting fingers (CF) or less and (5) odds of enucleation.
RESULTS: Of the 101 patients in our study, 48 had preceding cataract surgery and 53 had preceding IVI. There was an increased incidence of Streptococcus spp. endophthalmitis in post-IVI cases (24.53% vs 6.25%; OR 5.85; p=0.022). Endophthalmitis following IVI had increased likelihood of a final VA of CF or less (OR=6.0; p<0.01), decreased likelihood of any improvement in acuity following treatment (OR=0.13; p<0.01) and an increased likelihood of presenting within a week of the procedure (OR=3.93; p<0.01). Endophthalmitis caused by Streptococcus spp. was associated with increased likelihood of a final VA of CF or less (OR=10.2; p<0.01), decreased likelihood of any improvement in acuity following treatment (OR=0.06; p<0.01) and increased likelihood of enucleation (OR=17.11; p<0.01).
CONCLUSIONS: Endophthalmitis following IVI is associated with an increased incidence of Streptococcus spp. infection, earlier presentation and poorer visual outcomes when compared with endophthalmitis following cataract surgery.
Authors:
Matthew P Simunovic; Ryan B Rush; Alex P Hunyor; Andrew A Chang
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-03-24
Journal Detail:
Title:  The British journal of ophthalmology     Volume:  96     ISSN:  1468-2079     ISO Abbreviation:  Br J Ophthalmol     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-16     Completed Date:  2012-07-19     Revised Date:  2012-11-20    
Medline Journal Info:
Nlm Unique ID:  0421041     Medline TA:  Br J Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  862-6     Citation Subset:  IM    
Affiliation:
Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia. mps23@cantab.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiogenesis Inhibitors / administration & dosage
Anti-Bacterial Agents / therapeutic use
Bacteria / isolation & purification*
Cataract Extraction / adverse effects*
Endophthalmitis* / diagnosis,  microbiology,  therapy
Eye Enucleation
Eye Infections, Bacterial* / diagnosis,  microbiology,  therapy
Female
Glucocorticoids / administration & dosage
Humans
Incidence
Intravitreal Injections / adverse effects*
Male
Retrospective Studies
Time Factors
Visual Acuity / physiology
Vitrectomy
Vitreous Body / microbiology
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Anti-Bacterial Agents; 0/Glucocorticoids
Comments/Corrections
Comment In:
Br J Ophthalmol. 2012 Oct;96(10):1349-50; author reply 1350   [PMID:  22679333 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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