Clinical Manifestations and Prognostic Factors of Ocular Infection Associated with Orbital or Preseptal Cellulitis

Purpose: We assessed the clinical manifestations and prognostic factors associated with ocular infection in patients diagnosed with orbital and preseptal cellulitis.Methods: We enrolled 40 patients diagnosed with ocular infection accompanied by orbital and preseptal cellulitis between October 2015 and December 2021. We divided patients into the “treatment success group” (patients whose infection resolved) and the “treatment failure group” (patients whose infection worsened and required evisceration). Clinical characteristics, such as infection-related ocular findings and microbiological features, were analyzed retrospectively in both groups. Chi-square tests and logistic regression analyses were performed to identify prognostic factors associated with treatment failure.Results: The mean age of patients was 72.8 ± 11.92 years, with 17 (42.5%) of them being male. Among the patients, 11 had bacterial infections, and 3 had fungal infections. In total, 6 (15%) and 34 (85%) patients were classified into the treatment success and failure groups, respectively. The chi-square test revealed a significant association between the treatment failure group and several clinical factors, such as low best corrected visual acuity (BCVA), the logarithm of the minimum angle resolution (logMAR) BCVA > 2, low intraocular pressure (IOP) < 5 mmHg, large size of the corneal lesion, and the presence of hypopyon (p < 0.05). Furthermore, the multivariate logistic regression analysis identified hypopyon as a significant risk factor for treatment failure (p = 0.036).Conclusions: A significantly high treatment failure rate of 85% was observed in patients with ocular infections accompanied by orbital and preseptal cellulitis. Several clinical factors, such as low BCVA with logMAR BCVA > 2, IOP < 5 mmHg, large size of the corneal lesion, and a prolonged duration of symptoms demonstrated significant association with treatment failure. Notably, hypopyon is an important prognostic factor for treatment failure.