scholarly journals Treatment of Bilateral Endogenous Aspergillus Endophthalmitis with Multiple Intravitreal Voriconazole Injections with Good Visual Outcome

2021 ◽  
pp. 1002-1007
Author(s):  
Inas F. Aboobakar ◽  
Sally S. Ong ◽  
Akosua Nti ◽  
Kim Jiramongkolchai ◽  
J. Fernando Arevalo
Keyword(s):  
Visual Outcome ◽  
Intravitreal Injections ◽  
Endogenous Endophthalmitis ◽  
Visual Outcomes ◽  
Good Visual Outcome ◽  
The Right ◽  
Final Visual Outcome

Endogenous endophthalmitis caused by <i>Aspergillus</i> species tends to be very aggressive, often leading to devastating visual outcomes. Historically, intravitreal amphotericin injections have played a central role in management, but with variable visual outcomes and a risk of toxicity. Limited reports suggest that use of intravitreal voriconazole is a safe and efficacious alternative, though these cases were treated with only few intravitreal injections. Here, we report a case of bilateral endogenous <i>Aspergillus</i> endophthalmitis treated with 8 intravitreal voriconazole injections in the right eye and 11 in the left eye with good best-corrected final visual outcome (20/50 right eye and 20/40 left eye).

scholarly journals A 14-Year Retrospective Analysis of Endogenous Endophthalmitis in a Tertiary Referral Center of Southern Thailand

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Patama Bhurayanontachai ◽  
Phingphan Klongthanakit
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Patient Characteristics ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Gram Positive ◽  
Gram Negative ◽  
Visual Outcomes ◽  
Presenting Symptoms ◽  
Final Visual Outcome

Purpose. To investigate patient characteristics, clinical features, common causative organisms, and visual acuity outcomes in endogenous endophthalmitis. Methods. This was a retrospective chart analysis of patients with endogenous endophthalmitis between January 2006 and December 2019. Collected data included basic patient characteristics, presenting symptoms, causative organisms, treatments, and 3-month and 1-year visual outcomes. Results. Twenty-nine eyes of 27 patients were included in the study. The mean age of the patients was 45.4 ± 19.9 years, and 63% were female. Visual acuity at presentation ranged from counting fingers to no light perception. Systemic comorbidities presented in 66.7% of the patients, the majority of which were related to diabetes mellitus (48.1%). The most common primary infection was a urinary tract infection. Positive blood cultures were identified in 48.1% of patients, and positive cultures from vitreous and aqueous samples were identified in 59.3% and 31.6% of eyes, respectively. Among all the specimens, Gram-positive bacteria were identified in 55.5%, Gram-negative bacteria in 22.2%, fungi in 14.8%, and mixed organisms in 7.4%. Among ocular specimens, 61.1% contained Gram-positive organisms, 16.7% contained Gram-negative organisms, and 22.2% contained fungi. Streptococcus spp. was the most common causative organism. From 29 eyes, 18 (62.1%) underwent vitrectomy, and 12 (42.9%) underwent either evisceration or enucleation. Positive vitreous culture was significantly associated with unfavorable final visual outcome. Final visual acuity ranged from 20/125 to no light perception. Although visual improvement at 3 months was significantly better in younger patients, this had no impact on final visual outcome at 1 year. Conclusion. Eyes with positive vitreous cultures had significantly poorer visual outcomes. Despite full treatment coverage, visual prognosis was extremely poor and the rates of blindness and evisceration/enucleation were still high.

scholarly journals The Outcomes of Primary Scleral Buckling during Repair of Posterior Segment Open-Globe Injuries

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Dan Cohen ◽  
Jaime Levy ◽  
Tova Lifshitz ◽  
Nadav Belfair ◽  
Itamar Klemperer ◽  
...  
Keyword(s):  
Medical Center ◽  
Visual Outcome ◽  
Scleral Buckling ◽  
Posterior Segment ◽  
Control Group ◽  
Visual Outcomes ◽  
Open Globe ◽  
Retinal Complications ◽  
Final Visual Outcome ◽  
Open Globe Injuries

Objective. To compare visual outcomes of eyes which underwent primary scleral buckling (PSB) treatment during posterior segment open-globe injury (OGI) repair with eyes not treated with PSB.Methods. We retrospectively reviewed 38 eyes which underwent a posterior segment OGI repair with no preoperative evidence of retinal detachment (RD) at Soroka University Medical Center (1995–2010). 19 (50%) underwent scleral repair alone (control group) and the other 19 eyes were treated with PSB also (PSB group). We compared visual outcomes in these two groups and rates of subsequent postoperative complications.Results. Baseline characteristics of the groups were similar. Compared with the control group, the PSB group had statistically significant lower rates of proliferative vitreoretinopathy (PVR) (5.3% versus 38.4%,P<0.05) and a trend towards lower rates of RD (15.8% versus 41.1%,P=0.1). PSB group eyes had a statistically significant improvement of their best distance visual acuity (BDVA) with lower means of final BDVA-grade (P<0.05) and logMAR vision (P<0.05). Eyes in the control group had no improvement in these parameters.Conclusion. PSB procedure during posterior segment OGI repair may decrease the risk of subsequent retinal complications and improve final visual outcome.

scholarly journals Clinical profile and outcomes of descemetopexy in descemet membrane detachment (DMD) post-cataract surgery

2021 ◽  
Vol 7 (3) ◽  
pp. 482-485
Author(s):  
Harshika Chawla ◽  
Vishal Vohra ◽  
Asif Khan ◽  
Monika Bareja
Keyword(s):  
Risk Factors ◽  
Cataract Surgery ◽  
Sulfur Hexafluoride ◽  
Visual Outcome ◽  
Small Incision Cataract Surgery ◽  
Preoperative Risk Factors ◽  
Good Visual Outcome ◽  
The Mean ◽  
Final Visual Outcome ◽  
Descemet Membrane Detachment

To identify the preoperative risk factors, type of cataract surgery, cataract grade, and final visual outcome in patients undergoing descemetopexy for DMD. This was a retrospective study in which records of patients who underwent descemetopexy with either air or 20% sulfur hexafluoride (SF6) between 1st July 2014 and 30th June 2017. Grade of cataract, type of surgery, visual outcomes, and site of DMD were recorded.The mean age of the patients was 63.21 ± 5.8 years. Of the total 23 cases undergoing descemetopexy, 20 cases (87%) were after manual small incision cataract surgery (MSICS) and three cases (13%) were post phacoemulsification. The mean duration of presentation with a detachment was 13.03± 10.9 days (1-40 days). The most common types of DMD were total (34.8%) followed by temporal (30.4%) and superior (26.1%). Two patients (8.6%) obtained LOGMAR visual acuity (VA) of 0.0 and 5 of 23 patients (21.7%) achieved LOGMAR VA 0.3 after descemetopexy. Reattachment rates were 87% and three cases had reintervention. : This study identifies mature cataract and pre-existing corneal pathology as major risk factors for DMD during cataract surgery. DMD can be treated effectively and good visual outcome after successful descemetopexy.

scholarly journals Two Cases of Endogenous Endophthalmitis Caused by Gram-Positive Bacteria with Good Visual Outcome

2010 ◽  
Vol 1 (2) ◽  
pp. 56-62 ◽  
Author(s):  
Machiko Itoh ◽  
Junko Ikewaki ◽  
Kenichi Kimoto ◽  
Yuji Itoh ◽  
Kei Shinoda ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Endogenous Endophthalmitis ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Good Visual Outcome

GOOD VISUAL OUTCOME AFTER LISTERIA MONOCYTOGENES ENDOGENOUS ENDOPHTHALMITIS

Retina ◽  
1999 ◽  
Vol 19 (6) ◽  
pp. 566-567 ◽  
Author(s):  
VINCENT A. DERAMO ◽  
GAURAV K. SHAH ◽  
MARK GARDEN ◽  
JOSEPH I. MAGUIRE
Keyword(s):  
Listeria Monocytogenes ◽  
Visual Outcome ◽  
Endogenous Endophthalmitis ◽  
Good Visual Outcome

A Prospective Study on the Clinical and Microbiological Spectrum of Endophthalmitis in a Specific Region in Denmark

2015 ◽  
Vol 235 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Søren Solborg Bjerrum ◽  
Hassan Hamoudi ◽  
Alice Friis-Møller ◽  
Morten la Cour
Keyword(s):  
Surgical Complications ◽  
Surgical Intervention ◽  
Surgical Complication ◽  
Visual Outcome ◽  
Specific Region ◽  
Endogenous Endophthalmitis ◽  
Post Injection ◽  
Visual Outcomes ◽  
Poor Visual Outcome ◽  
Cataract Patients

Purpose: To study the clinical and microbiological spectrum of endophthalmitis with emphasis on clinical features, visual outcomes and risks of surgical complications. Methods: A prospective observational study was conducted between 2012 and 2013 in a specific region in Denmark. Patients were clinically examined before, during and after surgical intervention for endophthalmitis. Results: Fifty eyes with endophthalmitis were included. Endophthalmitis after cataract surgery (post-cataract), anti-VEGF (vascular endothelial growth factor) intravitreal injections (post-injection) and cases of endogenous endophthalmitis were responsible for 40, 28 and 18% of all cases, respectively. There was no difference in the microbiological spectrum in post-cataract patients and post-injection patients, but patients with post-cataract endophthalmitis presented statistically significantly more frequently with hypopyon and fibrin in the anterior chamber. Between 20 and 25% of post-cataract and post-injection endophthalmitis patients developed a surgical complication after primary surgical intervention for endophthalmitis, and this was statistically significantly associated with a poor visual outcome. There was no statistically significant difference in the risk of surgical complications in phakic and pseudophakic eyes with post-injection endophthalmitis. Of the 8 patients with endogenous endophthalmitis, 67% developed a surgical complication, and these patients had a high mortality. The visual outcome in the most common types of endophthalmitis was good, with 60% of post-cataract patients achieving a visual outcome ≥0.5, and 64% of post-injection patients only had a mild vision loss (1-14 ETDRS letters) or even gained vision. Conclusions: The endophthalmitis cases had a broad clinical spectrum. Surprisingly, endogenous endophthalmitis accounted for almost one fifth of all cases. Patients with post-cataract endophthalmitis had a clinically different presentation than patients with post-injection endophthalmitis. In general, the bacteria were low-virulent and the visual outcomes good, but a substantial part of the patients developed a surgical complication which was associated with a poor visual outcome.

scholarly journals Intravitreal injections as a leading cause of acute postoperative endophthalmitis—a regional survey in England

Eye ◽  
2021 ◽  
Author(s):  
Ariel Yuhan Ong ◽  
Axelle Rigaudy ◽  
Shafak Toufeeq ◽  
Julian Robins ◽  
Zaid Shalchi ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Absolute Risk ◽  
Vitreoretinal Surgery ◽  
Positive Culture ◽  
Visual Outcome ◽  
Intravitreal Injections ◽  
Postoperative Endophthalmitis ◽  
Regional Survey ◽  
Visual Outcomes ◽  
Clinical Records

Abstract Background To evaluate the characteristics, treatment patterns and outcomes of acute postoperative endophthalmitis. Methods Patients presenting with acute postoperative endophthalmitis between January 2017 to December 2019 were identified from hospital records in this multicentre retrospective cohort study. Clinical records were reviewed for visual acuity (VA) at various timepoints, cause of endophthalmitis, microbiological results, treatments and complications. Results Forty-six eyes of 46 patients were included. Intravitreal injections were the leading cause of acute postoperative endophthalmitis (n = 29; 63%), followed by cataract surgery (n = 8; 17%), vitreoretinal surgery (n = 7; 15%), and secondary intraocular lens insertion (n = 2, 4%). The absolute risk of endophthalmitis was 0.024% (1:4132) for intravitreal injections, 0.016% (1:6096) for cataract surgery, and 0.072% (1:1385) for vitreoretinal surgery. The majority of patients (n = 38; 83%) had better VA at 6 months compared to presentation, although fewer (n = 13; 28%) maintained similar or better VA compared to before the precipitating surgery. Twenty-four cases yielded positive culture results, of which staphylococcus epidermidis was the most commonly isolated organism. Microbiological yield was not associated with better final visual outcomes. Patients who underwent therapeutic vitrectomy (n = 15; 33%) had poorer VA at presentation, but subsequently achieved visual outcomes comparable to those who received medical treatment alone. There was no difference in time to presentation, visual outcome and retinal detachment rates among the different causative procedures. Conclusion Intravitreal injections were the most common cause of endophthalmitis in our region, primarily because of their higher frequency compared to other intraocular procedures. In this cohort, the primary procedure had no effect on presentation, management or visual outcomes.

scholarly journals Effect of time to primary repair on final visual outcome after open globe injury

2019 ◽  
Vol 103 (10) ◽  
pp. 1491-1494 ◽  
Author(s):  
Richard J Blanch ◽  
Jonathan Bishop ◽  
Hedayat Javidi ◽  
Philip Ian Murray
Keyword(s):  
Visual Acuity ◽  
Primary Repair ◽  
Demographic Data ◽  
Case Series ◽  
Visual Outcome ◽  
Final Visual Acuity ◽  
Visual Outcomes ◽  
Open Globe ◽  
Final Visual Outcome ◽  
Open Globe Injuries

Background/AimHistoric data suggest that open globe injuries should be repaired within 12–24 hours to reduce the risk of endophthalmitis. However, endophthalmitis is uncommon when systemic antibiotic prophylaxis is given. It is not clear whether delayed primary repair impacts visual outcomes in other ways or what is the optimum time to repair. We aimed to examine the effect of time to primary repair on visual outcomes.MethodsThis is a retrospective comparative case series including all open globe injuries presenting to the Birmingham Midland Eye Centre between 1 January 2014 and 15 March 2016. Presenting features, mechanism of injury, visual acuity at 6–12 months and demographic data were examined.Results56 open globe injuries were repaired, of which sufficient data for analysis were available on 52 cases. The mean time to primary repair was 1 day after injury (range 5 hours to 7 days). Final visual acuity at 6–12 months was related to the presenting visual acuity and the Ocular Trauma Score and to the time between injury and primary repair, with a reduction in predicted visual acuity of logarithm of the minimum angle of resolution of 0.37 for every 24 hours of delay (95% CI 0.14 to 0.6).DiscussionOpen globe injuries should be repaired promptly. Presenting visual acuity remains the strongest predictor of outcome; however, delay to primary repair also reduced final visual acuity, and any significant delay from injury to repair is likely to negatively impact final visual outcome.

Endogenous endophthalmitis and liver abscesses

2012 ◽  
Vol 11 (1) ◽  
pp. 27-27
Author(s):  
S Koay ◽  
◽  
S Jain ◽  
I Cropley ◽  
H Petrushkin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Diverticular Disease ◽  
Visual Outcome ◽  
Endogenous Endophthalmitis ◽  
Medical Comorbidities ◽  
Streptococcus Anginosus ◽  
Liver Abscesses ◽  
Good Visual Outcome ◽  
Prompt Diagnosis

Abstract We present a case of endogenous endophthalmitis secondary to liver abscesses, in a patient with no previous medical comorbidities or risk factors for immunosuppression. The patient presented with acute painless loss of vision and feeling generally unwell. Investigations revealed Streptococcus anginosus-constellatus bacteraemia, and evidence of diverticular disease that likely predisposed to the liver abscesses. Due to prompt diagnosis and administration of antibiotics, the patient had a good visual outcome. This case highlights the importance of being aware of endogenous endophthalmitis, as early diagnosis and prompt administration of antibiotics will optimise visual outcomes.

scholarly journals Visual outcomes of cataract surgery: An observational study of ten years from a tertiary eye care hospital in Pakistan

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Shahid Ahsan ◽  
Muhammad Saleh Memon ◽  
Sadia Bukhari ◽  
Tauseef Mahmood ◽  
Muhammad Faisal Fahim ◽  
...  
Keyword(s):  
Observational Study ◽  
Cataract Surgery ◽  
Visual Impairment ◽  
Visual Outcome ◽  
Care Hospital ◽  
Eye Care ◽  
Visual Outcomes ◽  
Creative Commons ◽  
Good Visual Outcome ◽  
Visual Assessments

Objectives: To observe and analyze the visual outcomes of cataract surgery of ten years at a tertiary eye care hospital, Karachi. Methods: An observational study with retrospective data search was conducted in Al Ibrahim Eye Hospital (AIEH), Karachi. Data of all adults (above 16 years) who underwent cataract surgery from 2010-2019 was retrieved from HIMS. Presence of opacity in the lens was labelled as cataract. Surgery was advised when patient’s BCVA was found to be 6/18. Visual assessments of the patients were done on day 01, one week and six weeks postoperatively. Postoperatively, 6/6 – 6/12 was considered as good, 6/18 as mild visual impairment, < 6/18 to 6/60 as moderate visual impairment and < 6/60 as severe visual impairment. Results: A total of 1,027,840 patients visited AIEH with different eye diseases. Among 1027840 individuals, cataract was identified in 88443 (8.6%). Surgery was advised to 58371 and performed in 38616. Records of operated cases (38616) were retrieved. Mean age of patients was 54.96±14.22 years. There were 20578 (53.29%) males and 18038 (46.71%) females who underwent surgery . At the end of sixth week, 3561 (18.4%), patients were found to have “good vision”, 12242 (63.43%) had mild visual impairment, 2676 (13.86%) had moderate visual impairment and 822 (4.26%) had severe visual impairment. Corneal Complications was the commonest cause (33.56%) at sixth week. Conclusions: The institution achieved WHO recommended criteria of “good visual outcome” (6/6 to 6/18) of 81.83% which is near to recommended ≥ 90% and severe visual impairment of 4.26%. doi: https://doi.org/10.12669/pjms.37.7.4428 How to cite this:Ahsan S, Memon MS, Bukhari S, Mahmood T, Fahim MF, Haseeb U, et al. Visual outcomes of cataract surgery: An observational study of ten years from a tertiary eye care hospital in Pakistan. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4428 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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