Transvitreal fibrinoid pseudoendophthalmitis after diabetic vitrectomy

Abstract

Objective: To describe the presentation and clinical course of noninfectious transvitreal fibrinoid response after vitrectomy for diabetic retinopathy.

Methods: Data collected from charts included age, gender, surgical indication, preoperative and serial visual acuities, vitrectomy procedures, and postoperative clinical characteristics of involved eye.

Results: Patients had a mean age of 65.6 years (51-82 years) with 5 women and 2 men. Patients had a range of diabetes duration from 4 to 27 years and a mean HgbA1C of 9.1 (5.8-14.1). Surgical indications included nonclearing vitreous hemorrhage (five), tractional retinal detachment (three), and clinically significant macular edema (one). All patients manifested transvitreal bands on postoperative Day 1 without anterior chamber reaction. Mean time to resolution of transvitreal bands was 8.75 days (4-15 days) on standard postoperative topical medications alone.

Conclusion: Transvitreal fibrinoid response after diabetic vitrectomy is a remarkable phenomenon that can occur in a wide variety of patients with diabetic retinopathy. It is important to differentiate this from infectious endophthalmitis, as this series of cases resolved spontaneously on topical medications alone.