A multicentre prospective study of post-traumatic endophthalmitis

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Abstract

Purpose:

Study the clinical and microbiological characteristics and the prognostic factors of post-traumatic endophthalmitis.

Methods:

Seventeen eyes were included between 2004 and 2010, with clinical and microbiological data collected prospectively. Conventional cultures and panbacterial PCR were performed on aqueous and vitreous samples.

Results:

Clinical signs of endophthalmitis were observed soon after trauma (1.5 ± 2.5 days). Laceration with an intraocular foreign body (IOFB) was noted in 53% of the patients. At admission, all patients had aqueous humour (71%) and/or vitreous (53%) samples. Fifteen patients (88%) underwent a pars plana vitrectomy. Bacteria were identified in 77% of the cases:Staphylococcus epidermidis(n=5),Streptococcus(n=4),Bacillus(n=2),Pseudomonas stuzeri(n=1), andStreptococcus salivariusandGemella haemolysans(multibacterial infection,n=1). Progression toward phthisis was observed in 35% of the cases; 41% of the patients recuperated visual acuity (VA) ≥20/40. A good final visual prognosis (≥20/40) was significantly associated with initial VA better than light perception (0% versus 70%, p=0.01) and absence of pupillary fibrin membrane (80% versus 20%, p=0.05). There was no correlation between visual prognosis and age, the type of laceration (corneal or scleral) or presence of an IOFB. We found a statistical trend toward an association between bacterial virulence and poor final VA.

Conclusion:

This series showed that better final VA outcomes were associated with initial VA better than light perception,S. epidermidisor culture-negative cases and absence of retinal detachment during the clinical course.

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