Clinical Features of Endogenous Endophthalmitis Secondary to Minimally Invasive Upper Urinary Tract Calculus Removal

ABSTRACT

Purpose

To evaluate endogenous endophthalmitis clinical features following minimally invasive removal of upper urinary tract calculi.

Methods

Medical records of twelve patients (17 eyes) with endogenous endophthalmitis secondary to minimally invasive upper urinary tract calculus removal were retrospectively reviewed.

Results

Diabetes mellitus was found in 7 patients (58%). 10 patients (83%) suffered from fever. The stone extraction and ocular symptom onset interval ranged from 2 to 22 days. All eyes presented as vitritis and fluffy yellow-white retinal exudates. Hypopyon was only found in 3 eyes (18%). 5 patients (42%) were misdiagnosed as uveitis which led to mismanagement. Ocular fluids were culture positive for only C. albicans in 12 eyes (71%). 10 of 12 eyes (83%) with silicon oil tamponade obtained a final BCVA≥0.05.

Conclusions

C. albicans was the most common endogenous endophthalmitis pathogen after urinary calculus removal by minimally invasive surgery. Pars plana vitrectomy with silicon oil tamponade may be helpful to achieve a favorable visual outcome. Routine ophthalmologic evaluation by the uveitis or vitreoretinal specialist may be necessary within 2 weeks after the urological procedures.

KEYWORDS:

• Urinary tract calculi
• endophthalmitis
• minimally invasive surgery
• fungi
• pars plana vitrectomy

Acknowledgments

We thank Dr. Xiaohu Ding for providing the study patient, and thank Jieting Zeng for data collection. This study was supported by the National Natural Science Foundation of China (No. 81760181) and the Fundamental Research Funds of the State Key Laboratory of Ophthalmology (No. 30306020240020130, 3030902113030) .

Declaration of Interest

None of the authors have a conflict of interest.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China (No. 81760181) and the Fundamental Research Funds of the State Key Laboratory of Ophthalmology (No. 30306020240020130, 3030902113030).