Endogenous Endophthalmitis at a Tertiary Referral Center in China: A Retrospective Study Over Three Decades

Abstract

ABSTRACT Purpose To investigate the etiology, pathogens, treatment, and prognosis of endogenous endophthalmitis (EE). Methods Patients diagnosed with EE over three decades at Peking Union Medical College Hospital were retrospectively reviewed and analyzed. Results A total of 97 eyes from 81 patients were included. Diabetes was the most common predisposing medical condition (34.6%). Klebsiella pneumoniae (31.3%) and Candida albicans (32.8%) were the most common pathogens. Liver abscess (20.6%) was the predominant cause EE due to liver abscess had a worse initial visual acuity (P < 0.05). Patients who initially underwent pars plana vitrectomy (PPV)+silicone oil tamponade underwent fewer total treatments (P < 0.05). In the past 10 years, the proportion of Gram-positive cocci, Gram-negative bacilli, and Candida showed an upward trend. Over the past 15 years, EE after liver abscess and immunosuppression has increased, while EE from genitourinary systems has decreased. Conclusion EE was a devastating intraocular disease with a poor visual prognosis. The initial condition and prognosis of EE after liver abscess were the worst. PPV+silicone oil tamponade as an initial treatment may reduce additional therapy.