Long-term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasone
Abstract Background The purpose of this study was to evaluate the role of systemic steroids in post-procedural endophthalmitis as the role of intravitreal steroids in treatment algorithms of endophthalmitis remain controversial. Methods This is a retrospective analysis from a single tertiary referra...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Ophthalmology |
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| Online Access: | http://link.springer.com/article/10.1186/s12886-020-01449-2 |
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| author | Christopher D. Conrady Richard M. Feist Albert T. Vitale Akbar Shakoor |
| author_facet | Christopher D. Conrady Richard M. Feist Albert T. Vitale Akbar Shakoor |
| author_sort | Christopher D. Conrady |
| collection | DOAJ |
| description | Abstract Background The purpose of this study was to evaluate the role of systemic steroids in post-procedural endophthalmitis as the role of intravitreal steroids in treatment algorithms of endophthalmitis remain controversial. Methods This is a retrospective analysis from a single tertiary referral center of all patients older than 18 years old that developed presumed post-procedure endophthalmitis and were treated at our center from 2009 to 2018. Results Eighty-three patients were followed after being treated for post-procedural endophthalmitis that either received systemic steroids or did not around the time of diagnosis. Almost 30 % of all patients regained a final visual acuity of 20/40 or better, while 31.2% had poor visual outcomes of count fingers or worse. Non-clearing debris was the most significant long-term complication. Visual improvement plateaued in 67.7% by 1 month after diagnosis and initial treatment in both groups. There was no difference in visual outcomes when comparing the sixteen patients that received systemic steroids and the sixty-seven that did not; however, no enucleation or evisceration was required in patients receiving systemic steroids. Five patients that did not receive systemic steroids required an enucleation or evisceration due to a blind, painful eye. Conclusions The use of systemic steroids does not seem to worsen long-term outcomes of endophthalmitis compared to those patients that did not receive them and they may prove beneficial in the most severe cases by reducing the risk of losing the globe altogether. |
| first_indexed | 2024-12-14T12:24:54Z |
| format | Article |
| id | doaj.art-e6637d6e2868477092ad2052faf1b823 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-14T12:24:54Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-e6637d6e2868477092ad2052faf1b8232022-12-21T23:01:22ZengBMCBMC Ophthalmology1471-24152020-05-012011810.1186/s12886-020-01449-2Long-term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasoneChristopher D. Conrady0Richard M. Feist1Albert T. Vitale2Akbar Shakoor3Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of UtahDepartment of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of UtahDepartment of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of UtahDepartment of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of UtahAbstract Background The purpose of this study was to evaluate the role of systemic steroids in post-procedural endophthalmitis as the role of intravitreal steroids in treatment algorithms of endophthalmitis remain controversial. Methods This is a retrospective analysis from a single tertiary referral center of all patients older than 18 years old that developed presumed post-procedure endophthalmitis and were treated at our center from 2009 to 2018. Results Eighty-three patients were followed after being treated for post-procedural endophthalmitis that either received systemic steroids or did not around the time of diagnosis. Almost 30 % of all patients regained a final visual acuity of 20/40 or better, while 31.2% had poor visual outcomes of count fingers or worse. Non-clearing debris was the most significant long-term complication. Visual improvement plateaued in 67.7% by 1 month after diagnosis and initial treatment in both groups. There was no difference in visual outcomes when comparing the sixteen patients that received systemic steroids and the sixty-seven that did not; however, no enucleation or evisceration was required in patients receiving systemic steroids. Five patients that did not receive systemic steroids required an enucleation or evisceration due to a blind, painful eye. Conclusions The use of systemic steroids does not seem to worsen long-term outcomes of endophthalmitis compared to those patients that did not receive them and they may prove beneficial in the most severe cases by reducing the risk of losing the globe altogether.http://link.springer.com/article/10.1186/s12886-020-01449-2EndophthalmitisSteroidsPost-procedureInfection |
| spellingShingle | Christopher D. Conrady Richard M. Feist Albert T. Vitale Akbar Shakoor Long-term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasone BMC Ophthalmology Endophthalmitis Steroids Post-procedure Infection |
| title | Long-term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasone |
| title_full | Long-term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasone |
| title_fullStr | Long-term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasone |
| title_full_unstemmed | Long-term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasone |
| title_short | Long-term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasone |
| title_sort | long term visual outcomes of endophthalmitis and the role of systemic steroids in addition to intravitreal dexamethasone |
| topic | Endophthalmitis Steroids Post-procedure Infection |
| url | http://link.springer.com/article/10.1186/s12886-020-01449-2 |
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