Endophthalmitis: state of the art

Endophthalmitis is a rare but potentially sight-threatening disease characterized by marked inflammation of intraocular tissues and fluids. This ocular pathology can be divided into broad categories of exogenous and endogenous endophthalmitis

Stephen Schwartz

2015

Scholarcy highlights

  • Endophthalmitis is a rare but potentially sight-threatening disease characterized by marked inflammation of intraocular tissues and fluids. This ocular pathology can be divided into broad categories of exogenous and endogenous endophthalmitis
  • In a more recent single-center series, 50% of eyes with acute-onset postoperative endophthalmitis had a final visual acuity of 20/40 or better and overall more than 36% had a final visual acuity of worse than 20/200.5 A large retrospective study reported that eyes with final visual acuity of 20/40 or better were more likely to be culture-negative or culture-positive for coagulase-negative Staphylococci
  • Endophthalmitis remains an important complication of surgery, injections, and trauma
  • The Endophthalmitis Vitrectomy Study provided important guidelines which remain relevant to this date. Those guidelines were derived from cases of acute-onset postoperative endophthalmitis following cataract surgery and secondary intraocular lens implantation and cannot be directly applied to other categories of endophthalmitis
  • It appears unlikely that large-scale randomized clinical trials will be performed on these other categories of endophthalmitis, management strategies continue to evolve by consensus and based on published clinical series
  • Accurate identification of causative organisms of endophthalmitis is important, especially in patients who fail to respond to initial broad-spectrum therapy
  • Newer ¬≠diagnostic techniques such as real-time polymerase chain reaction may provide more accurate and more sensitive results than traditional culture methods, at the present time these techniques are not widely available outside of major medical centers

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