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

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.

KEYWORDS:

• Candida albicans
• endogenous endophthalmitis
• Klebsiella pneumonia
• pars plana vitrectomy
• retrospective study

Abbreviation List

BCVA	=	Best-Corrected Visual Acuity
CF	=	Count Fingers
DM	=	Diabetes Mellitus
EE	=	Endogenous Endophthalmitis
IQR	=	Interquartile Range
IVI	=	Intravitreal Injection of Antibiotics
LogMAR	=	The Logarithm of the Minimum Angle of Resolution
LP	=	Light Perception
MODS	=	Multiple Organ Dysfunction Syndrome
NLP	=	No Light Perception
RD	=	Retinal Detachment
PPV	=	Pars Plana Vitrectomy
PUMCH	=	Peking Union Medical College Hospital

Disclosure statement

All authors have no relevant financial relationship to disclose. All authors have contributed significantly and are in agreement with the content of the manuscript.

Authors contributions

Wen-fei Zhang conceived this study and wrote the draft of the manuscript. Xin-yu Zhao and Huan Chen revised the manuscript. Li-hui Meng assisted in the draft. You-xin Chen conducted and coordinated the whole process. All authors have read the final manuscript and reached an agreement.

Data availability materials

The data used to support the findings of this study are available from the corresponding author upon request.

Ethical approval and consent to participate

The Declaration of Helsinki was followed by all the participant researchers, and the present study protocol was approved by the Institutional Review Board/Ethics Committee of PUMCH, approval number No. S-K1993. Written informed consent was obtained from each patient before the surgery.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09273948.2023.2198001.

Additional information

Funding

There was no funding source for this study. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit it for publication.