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. 2018 Oct 11;8(1):14.
doi: 10.1186/s12348-018-0158-3.

Endogenous endophthalmitis: a 9-year retrospective study at a tertiary referral hospital in Malaysia

Rosiah Muda  1 , Valarmathy Vayavari  2 , Deivanai Subbiah  3 , Hamisah Ishak  4 , Azian Adnan  3 , Shelina Oli Mohamed  5
Affiliations

Endogenous endophthalmitis: a 9-year retrospective study at a tertiary referral hospital in Malaysia

Rosiah Muda et al. J Ophthalmic Inflamm Infect. .

Abstract

Background: The objective of this study was to determine the clinical presentation, systemic risk factors, source of infective microorganism, treatment outcomes, and prognostic indicators of endogenous endophthalmitis at a main tertiary referral hospital for uveitis in Malaysia. A retrospective review of medical records of 120 patients (143 eyes) with endogenous endophthalmitis over a period of 9 years between January 2007 and December 2015 was undertaken.

Results: Identifiable systemic risk factors were present in 79.2%, with the majority related to diabetes mellitus (60.0%). The most common source of bacteremia was urinary tract infection (17.5%). A positive culture from ocular fluid or other body fluids was obtained in 82 patients (68.9%), and the blood was the highest source among all culture-positive results (42.0%). Gram-negative organisms accounted 42 cases (50.6%) of which Klebsiella pneumonia was the most common organism isolated (32.5%). Sixty-nine eyes (48.6%) were managed medically, and 73 eyes (51.4%) underwent vitrectomy. Final visual acuity of counting fingers (CF) or better was achieved in 100 eyes (73.0%). Presenting visual acuity of CF or better was significantly associated with a better final acuity of CF or better (p = 0.001).

Conclusions: The visual prognosis of endogenous endophthalmitis is often poor, leading to blindness. As expected, gram-negative organisms specifically Klebsiella pneumonia were the most common organisms isolated. Urinary tract infection was the main source of infection. Poor presenting visual acuity was significantly associated with grave visual outcomes. A high index of suspicion, early diagnosis, and treatment are crucial to salvage useful vision.

Keywords: Bacteria; Diabetes mellitus; Endogenous; Endophthalmitis; Fungal; Intravitreal injections; Visual acuity; Vitrectomy.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was obtained by the Medical Research and Ethics Committee (MREC) prior to the initiation of the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
The interval between the onset of ocular symptom and first presentation and the duration between systemic and ocular symptom
Fig. 2
Fig. 2
Blood, other body fluids, and vitreous culture organism
Fig. 3
Fig. 3
Other body fluid culture
Fig. 4
Fig. 4
Correlation between presenting visual acuity (LogMAR) and final visual acuity (LogMAR)
See this image and copyright information in PMC

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