Singapore medical journal · 2025
Bacterial exogenous endophthalmitis: a retrospective review of cases seen in a tertiary centre over 8 years.
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Chen David Ziyou, Yak Hng Kai Gerald, Choi Ming Tak Douglas Daniel, Goenadi Catherina J
Аннотация
INTRODUCTION: We aimed to describe the clinical course of bacterial exogenous endophthalmitis (EE) in a Singapore tertiery hospital and identify the risk factors associated with poor visual outcomes.
METHODS: This was a retrospective chart review of patients diagnosed with EE between 1 January 2014 and 31 December 2021. Microbiological data, aetiologies, treatment and visual acuities (VAs) were assessed. Poor visual outcome was defined as final VA poorer than 6/60.
RESULTS: Overall, 18 eyes of 18 patients were identified (postoperative endophthalmitis [POE]: n = 11, 61.1%; postinjection endophthalmitis [PIE]: n = 3, 17.7%; posttraumatic endophthalmitis: n = 2, 11.1% and keratitis-induced endophthalmitis: n = 2, 11.1%). Among the 11 POE patients, cataract surgery was the most common cause (n = 8, 72.7%). The median VA was hand movement (HM) (range from 6/30 to no light perception [NLP]) at presentation and HM (range from 6/6 to NLP) at final review. Patients with presenting VA of 6/60 or better were significantly less likely to have poor visual outcomes (0% vs. 78.6%, P = 0.01, Fisher's exact test). Coagulase-negative Staphylococcus (CoNS) was the most common organism (n = 6), followed by Enterococcus spp. (n = 3), Bacillus spp. and Pseudomonas spp. (n = 2 each). Compared to Gram-positive endophthalmitis, a greater proportion of patients with Gram-negative endophthalmitis had poor visual outcomes (100% vs. 33.5%, P = 0.06).
CONCLUSION: Between 2014 and 2021, POE was the most common cause of bacterial EE, followed by PIE. The most common organism isolated was CoNS. Patients with better presenting VA may have better visual prognosis after treatment.
METHODS: This was a retrospective chart review of patients diagnosed with EE between 1 January 2014 and 31 December 2021. Microbiological data, aetiologies, treatment and visual acuities (VAs) were assessed. Poor visual outcome was defined as final VA poorer than 6/60.
RESULTS: Overall, 18 eyes of 18 patients were identified (postoperative endophthalmitis [POE]: n = 11, 61.1%; postinjection endophthalmitis [PIE]: n = 3, 17.7%; posttraumatic endophthalmitis: n = 2, 11.1% and keratitis-induced endophthalmitis: n = 2, 11.1%). Among the 11 POE patients, cataract surgery was the most common cause (n = 8, 72.7%). The median VA was hand movement (HM) (range from 6/30 to no light perception [NLP]) at presentation and HM (range from 6/6 to NLP) at final review. Patients with presenting VA of 6/60 or better were significantly less likely to have poor visual outcomes (0% vs. 78.6%, P = 0.01, Fisher's exact test). Coagulase-negative Staphylococcus (CoNS) was the most common organism (n = 6), followed by Enterococcus spp. (n = 3), Bacillus spp. and Pseudomonas spp. (n = 2 each). Compared to Gram-positive endophthalmitis, a greater proportion of patients with Gram-negative endophthalmitis had poor visual outcomes (100% vs. 33.5%, P = 0.06).
CONCLUSION: Between 2014 and 2021, POE was the most common cause of bacterial EE, followed by PIE. The most common organism isolated was CoNS. Patients with better presenting VA may have better visual prognosis after treatment.