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AIMS: To describe and compare the causative organisms, clinical features and visual outcomes of endophthalmitis following intravitreal injection (IVI) to endophthalmitis following cataract surgery. METHODS: Patient population and setting: A retrospective case series of patients with acute endophthalmitis following either cataract surgery or IVI presenting to a tertiary referral centre--Sydney Eye Hospital--between 2007 and 2010. MAIN OUTCOME MEASURES: (1) identification of the causative organism; (2) time to presentation; (3) odds of improvement in visual acuity (VA) following treatment; (4) odds of final VA of counting fingers (CF) or less and (5) odds of enucleation. RESULTS: Of the 101 patients in our study, 48 had preceding cataract surgery and 53 had preceding IVI. There was an increased incidence of Streptococcus spp. endophthalmitis in post-IVI cases (24.53% vs 6.25%; OR 5.85; p=0.022). Endophthalmitis following IVI had increased likelihood of a final VA of CF or less (OR=6.0; p<0.01), decreased likelihood of any improvement in acuity following treatment (OR=0.13; p<0.01) and an increased likelihood of presenting within a week of the procedure (OR=3.93; p<0.01). Endophthalmitis caused by Streptococcus spp. was associated with increased likelihood of a final VA of CF or less (OR=10.2; p<0.01), decreased likelihood of any improvement in acuity following treatment (OR=0.06; p<0.01) and increased likelihood of enucleation (OR=17.11; p<0.01). CONCLUSIONS: Endophthalmitis following IVI is associated with an increased incidence of Streptococcus spp. infection, earlier presentation and poorer visual outcomes when compared with endophthalmitis following cataract surgery.

Original publication

DOI

10.1136/bjophthalmol-2011-301439

Type

Journal article

Journal

Br J Ophthalmol

Publication Date

06/2012

Volume

96

Pages

862 - 866

Keywords

Aged, Angiogenesis Inhibitors, Anti-Bacterial Agents, Bacteria, Cataract Extraction, Endophthalmitis, Eye Enucleation, Eye Infections, Bacterial, Female, Glucocorticoids, Humans, Incidence, Intravitreal Injections, Male, Retrospective Studies, Time Factors, Visual Acuity, Vitrectomy, Vitreous Body