Utility of optical coherence tomography in anticipation of visual outcomes in endophthalmitis

Abstract

Objective: To investigate whether specific findings on optical coherence tomography (OCT) in patients with endophthalmitis are correlated with visual prognosis.

Design: A single-center, retrospective, consecutive series.

Participants: Patients with endophthalmitis at Massachusetts Eye and Ear (2011-2021) who underwent spectral-domain OCT imaging were included.

Methods: OCT images were assessed over time, as well as their association with final best-corrected visual acuity.

Results: Out of the 429 eyes of 419 patients included, 232 eyes of 222 patients had available OCT data. The most common OCT finding was epiretinal membrane, with its incidence increasing over time and peaking at 6 months, after accounting for any media opacity that might obscure an underlying ERM. Mean central macular thickness and foveal thickness were lower in patients with good vision compared with patients with vision <20/100 at final follow-up (p = 0.023 and p < 0.001, respectively). Intraretinal fluid was more frequent in exogenous endophthalmitis (p = 0.038), whereas vitritis was more prevalent in endogenous endophthalmitis (p = 0.004). Absence of view and presence of subretinal fluid on OCT were associated with worse visual outcomes.

Conclusions: Endophthalmitis leads to varying pathology on optical coherence tomography based on the exogenous or endogenous subtype. Epiretinal membrane formation is the most common and increases over time. Certain findings, such as subretinal fluid, increased central macula thickness, and absence of view portend a worse visual outcome.