Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south India
Purpose: The purpose of this study is to evaluate the clinical profile, visual, anatomical and survival outcome of patients with endogenous endophthalmitis. Methods: Retrospective chart review of consecutive cases with endogenous endophthalmitis presenting from 2009-2016. Results: In our study, 41 e...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2020;volume=68;issue=5;spage=827;epage=833;aulast= |
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| author | Gopal S Pillai Kiran Krishnankutty Remadevi V Anilkumar Natasha Radhakrishnan Rehna Rasheed Greeshma C Ravindran |
| author_facet | Gopal S Pillai Kiran Krishnankutty Remadevi V Anilkumar Natasha Radhakrishnan Rehna Rasheed Greeshma C Ravindran |
| author_sort | Gopal S Pillai |
| collection | DOAJ |
| description | Purpose: The purpose of this study is to evaluate the clinical profile, visual, anatomical and survival outcome of patients with endogenous endophthalmitis. Methods: Retrospective chart review of consecutive cases with endogenous endophthalmitis presenting from 2009-2016. Results: In our study, 41 eyes of 34 patients were included. Most common co-morbidity associated with endogenous endophthalmitis was Diabetes Mellitus (70.7%) and most common infective foci was UTI (73.2%). Among the culture positive cases, fungi and bacteria were evenly distributed, 76.93% were Gram positive bacteria and 23.07% were Gram negative. Fungal endogenous endophthalmitis was more commonly seen in immunosuppressed state (72.7%) and bilateral cases (66.7%). The mean presenting vision (log MAR) of patients who died during the study were poor compared to those who survived (P = 0.014) Poor mean visual acuity at presentation was associated with more death (P = 0.014). Eyes with poor presenting vision, fungal isolates, culture positivity and immune suppression had poor visual and survival outcome. Poor visual outcome was observed more frequently in eyes with Aspergillus infection (85.7%) compared to Candida (75%) and bacteria (58.3%). Evisceration was done for 5 out of 41 eyes (12.2%). Vitrectomy rate was 53.7% in our study, with 40% of them showing overall improvement in vision. Conclusion: Endogenous endophthalmitis is a sight threatening condition associated with high mortality particularly when caused by Aspergillus spp. in immunocompromised patients. Contrary to the prior published reports of endogenous endophthalmitis outside India, we found an equal distribution of fungal and bacterial organisms among our cases, with predominance of Aspergillus among fungal isolates and Gram-positive organism among bacteria. Fungal infections, especially with Aspergillus spp., resulted in poor visual and survival outcome. |
| first_indexed | 2024-12-13T02:28:44Z |
| format | Article |
| id | doaj.art-19aa513c897f46329b4119e7aa64667f |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-12-13T02:28:44Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-19aa513c897f46329b4119e7aa64667f2022-12-22T00:02:33ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892020-01-0168582783310.4103/ijo.IJO_948_19Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south IndiaGopal S PillaiKiran Krishnankutty RemadeviV AnilkumarNatasha RadhakrishnanRehna RasheedGreeshma C RavindranPurpose: The purpose of this study is to evaluate the clinical profile, visual, anatomical and survival outcome of patients with endogenous endophthalmitis. Methods: Retrospective chart review of consecutive cases with endogenous endophthalmitis presenting from 2009-2016. Results: In our study, 41 eyes of 34 patients were included. Most common co-morbidity associated with endogenous endophthalmitis was Diabetes Mellitus (70.7%) and most common infective foci was UTI (73.2%). Among the culture positive cases, fungi and bacteria were evenly distributed, 76.93% were Gram positive bacteria and 23.07% were Gram negative. Fungal endogenous endophthalmitis was more commonly seen in immunosuppressed state (72.7%) and bilateral cases (66.7%). The mean presenting vision (log MAR) of patients who died during the study were poor compared to those who survived (P = 0.014) Poor mean visual acuity at presentation was associated with more death (P = 0.014). Eyes with poor presenting vision, fungal isolates, culture positivity and immune suppression had poor visual and survival outcome. Poor visual outcome was observed more frequently in eyes with Aspergillus infection (85.7%) compared to Candida (75%) and bacteria (58.3%). Evisceration was done for 5 out of 41 eyes (12.2%). Vitrectomy rate was 53.7% in our study, with 40% of them showing overall improvement in vision. Conclusion: Endogenous endophthalmitis is a sight threatening condition associated with high mortality particularly when caused by Aspergillus spp. in immunocompromised patients. Contrary to the prior published reports of endogenous endophthalmitis outside India, we found an equal distribution of fungal and bacterial organisms among our cases, with predominance of Aspergillus among fungal isolates and Gram-positive organism among bacteria. Fungal infections, especially with Aspergillus spp., resulted in poor visual and survival outcome.http://www.ijo.in/article.asp?issn=0301-4738;year=2020;volume=68;issue=5;spage=827;epage=833;aulast=endogenous endophthalmitismicrobiologyrisk factorstreatment outcomevisual acuity |
| spellingShingle | Gopal S Pillai Kiran Krishnankutty Remadevi V Anilkumar Natasha Radhakrishnan Rehna Rasheed Greeshma C Ravindran Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south India Indian Journal of Ophthalmology endogenous endophthalmitis microbiology risk factors treatment outcome visual acuity |
| title | Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south India |
| title_full | Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south India |
| title_fullStr | Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south India |
| title_full_unstemmed | Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south India |
| title_short | Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south India |
| title_sort | clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south india |
| topic | endogenous endophthalmitis microbiology risk factors treatment outcome visual acuity |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2020;volume=68;issue=5;spage=827;epage=833;aulast= |
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