Changes in the clinical features and prognostic factors of endogenous endophthalmitis: fifteen years of clinical experience in Korea

Retina. 2012 May;32(5):977-84. doi: 10.1097/IAE.0b013e318228e312.

Abstract

Purpose: To identify changes in the clinical features, management, and prognostic factors of endogenous endophthalmitis in Korea from 1996 through 2010.

Methods: We conducted a retrospective review of medical records of patients diagnosed with endogenous endophthalmitis from January 1996 to December 2010, which was divided into 3 periods: 1996 to 2000, 2001 to 2005, and 2006 to 2010. Variables included age, source of infection, systemic conditions, initial and final visual acuities, causative organisms, and treatment.

Results: Endophthalmitis was identified in 80 patients (97 eyes). Diabetes (42.5%) and liver cirrhosis (20%) were the common systemic problems in these patients. Liver abscess (25%) was the most common infection focus of the endophthalmitis. Klebsiella pneumoniae (48.4%) was the common causative agent, although more recently, endophthalmitis caused by gram-positive cocci has increased in frequency. The use of vitrectomy as an initial treatment has increased during the past 5 years. Good initial visual acuity greater than counting fingers (P < 0.001), early vitrectomy in patients with initially good visual presentation (P = 0.035), and gram-positive cocci (P = 0.033) as a causative agent were significantly related to a successful visual outcome.

Conclusion: Although the prognosis of endogenous endophthalmitis is generally poor in most patients, some eyes can have relatively good visual outcomes if treated appropriately and early enough.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteria / isolation & purification
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / etiology
  • Endophthalmitis / diagnosis
  • Endophthalmitis / microbiology*
  • Endophthalmitis / therapy
  • Eye Evisceration
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / microbiology*
  • Eye Infections, Bacterial / therapy
  • Eye Infections, Fungal / diagnosis
  • Eye Infections, Fungal / microbiology*
  • Eye Infections, Fungal / therapy
  • Female
  • Fungi / isolation & purification
  • Humans
  • Liver Abscess / diagnosis
  • Liver Abscess / microbiology
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / etiology
  • Male
  • Middle Aged
  • Prognosis
  • Republic of Korea
  • Retrospective Studies
  • Risk Factors
  • Visual Acuity
  • Vitrectomy
  • Young Adult

Substances

  • Anti-Bacterial Agents