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Indian Journal of Medical Sciences
Medknow Publications on behalf of Indian Journal of Medical Sciences Trust
ISSN: 0019-5359
EISSN: 0019-5359
Vol. 60, No. 11, 2006, pp. 454-460
Bioline Code: ms06067
Full paper language: English
Document type: Research Article
Document available free of charge

Indian Journal of Medical Sciences, Vol. 60, No. 11, 2006, pp. 454-460

 en Evaluation of outcome of various treatment methods for endogenous endophthalmitis
Keswani Tulsi, Ahuja Vijay, Changulani Manish

Abstract

AIM: To evaluate the role of different treatment methods (intravitreal antibiotics and vitrectomy) for endogenous endophthalmitis and assess the outcome.
Materials and METHODS: This is a retrospective observational case study. Sixteen cases of endogenous endophthalmitis noted in 14 patients between October 2000 and April 2004 were reviewed. Two patients had bilateral disease. Patients were followed up for a mean of 3 months (range, 1-12 months).
RESULTS: Vitreous and aqueous cultures were positive in 8 (66%) cases and 3 (75%) cases respectively. Fungal isolates occurred in 4 (33%) cases, out of which 3 were due to candida, gram-positive isolates occurred in 2 (16%) and gram-negative isolates in 2 (16%) of the cases. Initial treatment included vitreous tap and injection of intravitreal medication in 12 (75%) cases and pars plana vitrectomy with injection of intravitreal medication in 3 (19%) cases. Final visual outcomes were obtainable for13 cases (1 patient died and 1 patient was lost to follow-up and 1 eye was eviscerated). Five (43%) of these cases achieved visual acuity of 6/60 or better and 8 (56%) eyes achieved a visual acuity less than 6/60. Risk factors mainly associated with the disease were uncontrolled diabetes mellitus, chronic renal failure, renal transplant, abdominal surgeries and septicemia.
CONCLUSION: Our experience suggests that endogenous endophthalmitis is generally associated with poor visual outcome. Prompt treatment with intravitreal antibiotics and vitrectomy can result in improvement in ocular signs and visual acuity in majority of the patients. The patients with culture-positive endogenous endophthalmitis are more likely to have fungal isolates with a predominance of candida. Fungal endopthalmitis has a poor visual outcome as compared to bacterial endophthalmitis.

Keywords
Endogenous, endophthalmitis, intravitreal antibiotics, vitrectomy

 
© Copyright 2006 Indian Journal of Medical Sciences.
Alternative site location: http://www.indianjmedsci.org/

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