Abstract
Bacterial endophthalmitis is an intraocular infection that causes rapid vison loss. Pathogens can infect the intraocular space directly (exogenous endophthalmitis (ExE)) or indirectly (endogenous endophthalmitis (EnE)). To identify predictive factors for the visual prognosis of Japanese patients with bacterial endophthalmitis, we retrospectively examined the bacterial endophthalmitis characteristics of 314 Japanese patients and performed statistics using these clinical data. Older patients, with significantly more severe clinical symptoms, were prevalent in the ExE group compared with the EnE group. However, the final best-corrected visual acuity (BCVA) was not significantly different between the ExE and EnE groups. Bacteria isolated from patients were not associated with age, sex, or presence of eye symptoms. Genus Streptococcus, Streptococcus pneumoniae, and Enterococcus were more prevalent in ExE patients than EnE patients and contributed to poor final BCVA. The presence of eye pain, bacterial identification, and poor BCVA at baseline were risk factors for final visual impairment.
Highlights
Bacterial endophthalmitis is a purulent inflammation of the intraocular fluids, i.e., the vitreous and the aqueous humor that leads to significant visual loss with progression in hours to days
We showed here the characteristics of 314 Japanese patients (350 eyes) with bacterial endophthalmitis
Bacterial identification, and poor best-corrected visual acuity (BCVA) at baseline contributed to the final visual impairment
Summary
Bacterial endophthalmitis is a purulent inflammation of the intraocular fluids, i.e., the vitreous and the aqueous humor that leads to significant visual loss with progression in hours to days. Exogenous endophthalmitis (ExE) is mainly caused by eye surgery [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23] and trauma [24,25,26] due to the direct infection of pathogens into the eye from outside. Despite recent advances in the science and technology for the identification of pathogens using polymerase chain reaction (PCR) [39,40] and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry [41,42], new antibiotics, and minimally invasive vitrectomy, bacterial endophthalmitis remains a severe intraocular infection that causes a high risk of vision loss. We retrospectively examined the characteristics of 314 bacterial endophthalmitis cases seen in multiple institutions of the Japan Clinical REtina STudy group (J-CREST) in a 10-year span and performed statistics to identify predictive factors for visual prognosis using these clinical data
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