Prognostic factors associated with visual outcome of salvageable eyes with posttraumatic endophthalmitis

Hua Yan,Honghe Xia,Weiqi Chen,Haoyu Chen,Danny Siu-Chun Ng,Xuehui Lu,Chuang Jin

doi:10.1038/s41598-019-49117-w

Abstract

The purpose of this study is to evaluate the prognostic factors associated with visual outcomes in the salvageable eyes with posttraumatic endophthalmitis. We retrospectively reviewed the medical records of all patients diagnosed with posttraumatic endophthalmitis in our hospital between 2008 and 2015. The following information was collected: age, sex, etiology, past medical history, clinical manifestations, wound location, microbiology, blood leukocyte counts, types of interventions, initial visual acuities and final visual acuities. Univariate and multivariate analyses were used to explore the factors associated with final best-corrected visual acuity. In total, 98 eyes of 98 patients were included in our study. Fifty-seven eyes underwent vitrectomy, 27 of them had silicone oil tamponade, 38 eyes received intravitreal ceftazidime only and 3 eyes received intracameral ceftazidime. In univariate analysis, poor initial visual acuity, presence of intraocular foreign body, number of intravitreal injections, retinal detachment and Zone 3 injury were associated with poor visual outcome. In multivariable analysis, poor initial visual acuity, presence of intraocular foreign body and number of intravitreal injections were independently associated with poor visual outcome. The silicone oil group had fewer repeated intravitreal injections than the group without oil tamponade. We concluded that the visual outcome of salvageable eyes with posttraumatic endophthalmitis is associated with initial visual acuity, presence of intraocular foreign body and number of intravitreal antibiotic injections.

Highlights

Endophthalmitis is a severe inflammatory disease that may be caused by trauma, intraocular surgery, infectious keratitis and endogenous causes
Our study found that poor initial visual acuity, number of intravitreal injection and presence of intraocular foreign body were independent prognostic factors associated with visual outcome of salvageable eyes with posttraumatic endophthalmitis
We found that vitrectomy with silicone oil tamponade was associated with a reduced number of intravitreal injections

Summary

Introduction

Endophthalmitis is a severe inflammatory disease that may be caused by trauma, intraocular surgery, infectious keratitis and endogenous causes. It leads to blindness in the absence of timely management. There were few studies suggested that the presence of intraocular foreign body was not associated with final visual acuity of posttraumatic endophthalmitis[2,4,8]. Asencio et al.[2] reported that the presence of intraocular foreign body was associated with worse final visual acuity. The study reported that when initial visual acuity was better than hand movements, there was no significant difference in visual outcome for patients that received intravitreal antibiotics compared to those who received vitrectomy. We report the prognostic factors associated with visual outcomes in salvageable eyes with posttraumatic endophthalmitis

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