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Review
. 2015 Jan 8:9:95-108.
doi: 10.2147/OPTH.S76406. eCollection 2015.

Endophthalmitis: state of the art

Kamyar Vaziri  1 , Stephen G Schwartz  1 , Krishna Kishor  1 , Harry W Flynn Jr  1
Affiliations
Review

Endophthalmitis: state of the art

Kamyar Vaziri et al. Clin Ophthalmol. .

Abstract

Endophthalmitis is an uncommon diagnosis but can have devastating visual outcomes. Endophthalmitis may be endogenous or exogenous. Exogenous endophthalmitis is caused by introduction of pathogens through mechanisms such as ocular surgery, open-globe trauma, and intravitreal injections. Endogenous endophthalmitis occurs as a result of hematogenous spread of bacteria or fungi into the eye. These categories of endophthalmitis have different risk factors and causative pathogens, and thus require different diagnostic, prevention, and treatment strategies. Novel diagnostic techniques such as real-time polymerase chain reaction (RT-PCR) have been reported to provide improved diagnostic results over traditional culture techniques and may have a more expanded role in the future. While the role of povidone-iodine in prophylaxis of postoperative endophthalmitis is established, there remains controversy with regard to the effectiveness of other measures, including prophylactic antibiotics. The Endophthalmitis Vitrectomy Study (EVS) has provided us with valuable treatment guidelines. However, these guidelines cannot be directly applied to all categories of endophthalmitis, highlighting the need for continued research into attaining improved treatment outcomes.

Keywords: endogenous; endophthalmitis; exogenous; intravitreal injection; postoperative.

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Figures

Figure 1
Figure 1
Acute-onset postoperative endophthalmitis (note the sutured corneal wound and hypopyon).
Figure 2
Figure 2
Delayed-onset (chronic) postoperative endophthalmitis (note the small hypopyon and peripheral intracapsular infiltrates).
Figure 3
Figure 3
Bleb-related endophthalmitis (note the purulent filtering bleb and hypopyon).
Figure 4
Figure 4
Endophthalmitis following intravitreal injection (note the chemosis and hypopyon).
Figure 5
Figure 5
Posttraumatic endophthalmitis (note the sutured corneal wound and hypopyon).
See this image and copyright information in PMC

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