Clinical presentation and outcome of patients with endogenous endophthalmitis.

Abstract

Purpose: The study aims to evaluate the clinical characteristics, risk factors, microbiological findings, and visual outcomes, as well as patient and eye survival, of patients diagnosed with endogenous endophthalmitis (EE).

Methods: A retrospective study was conducted on 29 eyes from 21 patients diagnosed with EE.

Results: The mean age of presentation was 56.8 years, with a male predominance. The most common predisposing factors were diabetes mellitus and recurrent urinary tract infections. 42.9% of patients exhibited positive blood cultures, whereas positive vitreous cultures were detected in 38.1% of patients. The majority of cases were caused by bacterial infections. The median final visual acuity was 2 (0.1-2.9) LogMAR, with no significant difference between the bacterial and fungal groups. According to the Kaplan-Meier analysis, first-year survival rate was 90.5%, and the rate of eye preservation (at least one eye) was significantly lower in the presence of immunosuppresant drug usage (p = 0.004, Log Rank = 8.348).

Conclusion: Endogenous endophthalmitis typically has a poor visual prognosis, with the loss of anatomical integrity or mortality not being uncommon. The findings of the study provide insights into the clinical and microbiological characteristics of patients with EE in Turkey. Initial visual acuity and severe intraocular inflammation at presentation have been identified as predictors of poor visual outcomes. The negative impact of immunosuppressive drug use on globe survival has been noted. In patients using immunosuppressive drugs, healthcare providers being vigilant towards infectious pathologies and prompt intervention may increase the chances of success in EE treatment.