Retinal Vasculitis and Posterior Pole Hypopyon in Exogenous Bacterial Endophthalmitis
Purpose
To investigate the clinical settings and visual outcomes in eyes with exogenous bacterial endophthalmitis with retinal vasculitis and posterior pole hypopyon.
Methods
Retrospective, consecutive, interventional case series.
Results
The clinical settings included cataract extraction (n = 30), trauma (n = 5), trabeculectomy with bleb (n = 2), penetrating keratoplasty (n = 1), pars plana vitrectomy (PPV) (n = 1), and iridoplasty (n = 1). Presenting visual acuity (VA) ranged from hand motions to no light perception. Patients were treated with PPV with the infusion of antibiotics (10 μg/mL vancomycin and either 40 μg/mL ceftazidime or 10 μg/mL amikacin) and dexamethasone (10 μg/mL), removal of vitreous and posterior pole hypopyon, and intravitreal injections of antibiotics and dexamethasone at the end of surgery. The risk factors for poor visual outcomes were initial poor VA (P < .001), older age (P = .021), virulent organism (P < .001), diffuse retinal vasculitis (P = .009), diffuse posterior pole hypopyon (P < .001), ocular hypertension (P < .001), retinal detachment (P = .005), and silicone oil tamponade (P = .004). Multivariate linear regression revealed that diffuse posterior pole hypopyon (P = .005) and ocular hypertension (P = .012) were the significant independent factors for poor visual outcomes.
Conclusion
Diffuse posterior pole hypopyon and ocular hypertension are critical prognostic factors for poor visual outcomes. Most cases of retinal vasculitis and focal posterior pole hypopyon can resolve without sequelae, and favorable visual outcomes can be achieved in these cases.
Conflict of interest
No
Author 1
Last name
CHEN
Initials of first name(s)
KJ
Department
Ophthalmology
City
Taoyuan
Country
Taiwan
Author 2
Last name
CHEN
Initials of first name(s)
YP
Department
Ophthalmology
City
Taoyuan
Country
Taiwan
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