MICROBIOLOGIC SPECTRUM AND VISUAL OUTCOMES OF ACUTE-ONSET ENDOPHTHALMITIS UNDERGOING THERAPEUTIC PARS PLANA VITRECTOMY

Jayanth Sridhar, Yoshihiro Yonekawa, Ajay Kuriyan, Anthony Joseph, Benjamin J. Thomas, Michelle C. Liang, Nadim Rayess, Nidhi Relhan, Jeremy D. Wolfe, Chirag P. Shah, Andre J. Witkin, Harry W Flynn, Sunir J. Garg

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Abstract

PURPOSE:: To report the clinical presentation, microbiologic spectrum, and visual outcomes associated with acute-onset infectious endophthalmitis undergoing therapeutic pars plana vitrectomy. METHODS:: Multicenter interventional retrospective noncomparative consecutive case series. Billing records were reviewed to identify all charts for patients undergoing pars plana vitrectomy within 14 days of diagnosis of acute-onset infectious endophthalmitis over a 4-year period at 5 large tertiary referral retina practices. Statistical analysis was performed to assess for factors associated with visual outcomes. RESULTS:: Seventy patients were identified. The most common clinical setting was postcataract surgery (n = 20). Only 3 patients (4.3%) presented with 20/400 or better visual acuity (VA). Although most of the patients initially underwent vitreous tap and intravitreal antibiotic injection (n = 47, 67.1%), all patients eventually underwent pars plana vitrectomy within 14 days of presentation with 68.5% (48/70) of patients undergoing pars plana vitrectomy within 48 hours of presentation. Positive intraocular cultures were obtained in 56 patients (80%). The most common identified organism was Streptococcus sp (n = 19). Visual acuity at last follow-up was 20/400 or better in 19 patients (27.1%). Three patients underwent evisceration or enucleation (4.3%). Last recorded postoperative VA (mean LogMAR 1.99 ± 0.94, Snellen VA equivalent finger count) improved from presenting VA (mean LogMAR 2.37 ± 0.38, Snellen VA hand motions) (P ≤ 0.001). There was no statistically significant correlation between the underlying etiology or the timing of surgery with this VA outcome. CONCLUSION:: Although less than one-third of patients achieved 20/400 or better VA, this VA often improved significantly from presenting VA.

Original languageEnglish (US)
JournalRetina
DOIs
StateAccepted/In press - Oct 21 2016

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Endophthalmitis
Temazepam
Vitrectomy
Visual Acuity
Therapeutics
Intravitreal Injections
Streptococcus
Fingers
Retina
Referral and Consultation
Hand
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Sridhar, J., Yonekawa, Y., Kuriyan, A., Joseph, A., Thomas, B. J., Liang, M. C., ... Garg, S. J. (Accepted/In press). MICROBIOLOGIC SPECTRUM AND VISUAL OUTCOMES OF ACUTE-ONSET ENDOPHTHALMITIS UNDERGOING THERAPEUTIC PARS PLANA VITRECTOMY. Retina. https://doi.org/10.1097/IAE.0000000000001358

MICROBIOLOGIC SPECTRUM AND VISUAL OUTCOMES OF ACUTE-ONSET ENDOPHTHALMITIS UNDERGOING THERAPEUTIC PARS PLANA VITRECTOMY. / Sridhar, Jayanth; Yonekawa, Yoshihiro; Kuriyan, Ajay; Joseph, Anthony; Thomas, Benjamin J.; Liang, Michelle C.; Rayess, Nadim; Relhan, Nidhi; Wolfe, Jeremy D.; Shah, Chirag P.; Witkin, Andre J.; Flynn, Harry W; Garg, Sunir J.

In: Retina, 21.10.2016.

Research output: Contribution to journalArticle

Sridhar, J, Yonekawa, Y, Kuriyan, A, Joseph, A, Thomas, BJ, Liang, MC, Rayess, N, Relhan, N, Wolfe, JD, Shah, CP, Witkin, AJ, Flynn, HW & Garg, SJ 2016, 'MICROBIOLOGIC SPECTRUM AND VISUAL OUTCOMES OF ACUTE-ONSET ENDOPHTHALMITIS UNDERGOING THERAPEUTIC PARS PLANA VITRECTOMY', Retina. https://doi.org/10.1097/IAE.0000000000001358
Sridhar, Jayanth ; Yonekawa, Yoshihiro ; Kuriyan, Ajay ; Joseph, Anthony ; Thomas, Benjamin J. ; Liang, Michelle C. ; Rayess, Nadim ; Relhan, Nidhi ; Wolfe, Jeremy D. ; Shah, Chirag P. ; Witkin, Andre J. ; Flynn, Harry W ; Garg, Sunir J. / MICROBIOLOGIC SPECTRUM AND VISUAL OUTCOMES OF ACUTE-ONSET ENDOPHTHALMITIS UNDERGOING THERAPEUTIC PARS PLANA VITRECTOMY. In: Retina. 2016.
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abstract = "PURPOSE:: To report the clinical presentation, microbiologic spectrum, and visual outcomes associated with acute-onset infectious endophthalmitis undergoing therapeutic pars plana vitrectomy. METHODS:: Multicenter interventional retrospective noncomparative consecutive case series. Billing records were reviewed to identify all charts for patients undergoing pars plana vitrectomy within 14 days of diagnosis of acute-onset infectious endophthalmitis over a 4-year period at 5 large tertiary referral retina practices. Statistical analysis was performed to assess for factors associated with visual outcomes. RESULTS:: Seventy patients were identified. The most common clinical setting was postcataract surgery (n = 20). Only 3 patients (4.3{\%}) presented with 20/400 or better visual acuity (VA). Although most of the patients initially underwent vitreous tap and intravitreal antibiotic injection (n = 47, 67.1{\%}), all patients eventually underwent pars plana vitrectomy within 14 days of presentation with 68.5{\%} (48/70) of patients undergoing pars plana vitrectomy within 48 hours of presentation. Positive intraocular cultures were obtained in 56 patients (80{\%}). The most common identified organism was Streptococcus sp (n = 19). Visual acuity at last follow-up was 20/400 or better in 19 patients (27.1{\%}). Three patients underwent evisceration or enucleation (4.3{\%}). Last recorded postoperative VA (mean LogMAR 1.99 ± 0.94, Snellen VA equivalent finger count) improved from presenting VA (mean LogMAR 2.37 ± 0.38, Snellen VA hand motions) (P ≤ 0.001). There was no statistically significant correlation between the underlying etiology or the timing of surgery with this VA outcome. CONCLUSION:: Although less than one-third of patients achieved 20/400 or better VA, this VA often improved significantly from presenting VA.",
author = "Jayanth Sridhar and Yoshihiro Yonekawa and Ajay Kuriyan and Anthony Joseph and Thomas, {Benjamin J.} and Liang, {Michelle C.} and Nadim Rayess and Nidhi Relhan and Wolfe, {Jeremy D.} and Shah, {Chirag P.} and Witkin, {Andre J.} and Flynn, {Harry W} and Garg, {Sunir J.}",
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AU - Sridhar, Jayanth

AU - Yonekawa, Yoshihiro

AU - Kuriyan, Ajay

AU - Joseph, Anthony

AU - Thomas, Benjamin J.

AU - Liang, Michelle C.

AU - Rayess, Nadim

AU - Relhan, Nidhi

AU - Wolfe, Jeremy D.

AU - Shah, Chirag P.

AU - Witkin, Andre J.

AU - Flynn, Harry W

AU - Garg, Sunir J.

PY - 2016/10/21

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N2 - PURPOSE:: To report the clinical presentation, microbiologic spectrum, and visual outcomes associated with acute-onset infectious endophthalmitis undergoing therapeutic pars plana vitrectomy. METHODS:: Multicenter interventional retrospective noncomparative consecutive case series. Billing records were reviewed to identify all charts for patients undergoing pars plana vitrectomy within 14 days of diagnosis of acute-onset infectious endophthalmitis over a 4-year period at 5 large tertiary referral retina practices. Statistical analysis was performed to assess for factors associated with visual outcomes. RESULTS:: Seventy patients were identified. The most common clinical setting was postcataract surgery (n = 20). Only 3 patients (4.3%) presented with 20/400 or better visual acuity (VA). Although most of the patients initially underwent vitreous tap and intravitreal antibiotic injection (n = 47, 67.1%), all patients eventually underwent pars plana vitrectomy within 14 days of presentation with 68.5% (48/70) of patients undergoing pars plana vitrectomy within 48 hours of presentation. Positive intraocular cultures were obtained in 56 patients (80%). The most common identified organism was Streptococcus sp (n = 19). Visual acuity at last follow-up was 20/400 or better in 19 patients (27.1%). Three patients underwent evisceration or enucleation (4.3%). Last recorded postoperative VA (mean LogMAR 1.99 ± 0.94, Snellen VA equivalent finger count) improved from presenting VA (mean LogMAR 2.37 ± 0.38, Snellen VA hand motions) (P ≤ 0.001). There was no statistically significant correlation between the underlying etiology or the timing of surgery with this VA outcome. CONCLUSION:: Although less than one-third of patients achieved 20/400 or better VA, this VA often improved significantly from presenting VA.

AB - PURPOSE:: To report the clinical presentation, microbiologic spectrum, and visual outcomes associated with acute-onset infectious endophthalmitis undergoing therapeutic pars plana vitrectomy. METHODS:: Multicenter interventional retrospective noncomparative consecutive case series. Billing records were reviewed to identify all charts for patients undergoing pars plana vitrectomy within 14 days of diagnosis of acute-onset infectious endophthalmitis over a 4-year period at 5 large tertiary referral retina practices. Statistical analysis was performed to assess for factors associated with visual outcomes. RESULTS:: Seventy patients were identified. The most common clinical setting was postcataract surgery (n = 20). Only 3 patients (4.3%) presented with 20/400 or better visual acuity (VA). Although most of the patients initially underwent vitreous tap and intravitreal antibiotic injection (n = 47, 67.1%), all patients eventually underwent pars plana vitrectomy within 14 days of presentation with 68.5% (48/70) of patients undergoing pars plana vitrectomy within 48 hours of presentation. Positive intraocular cultures were obtained in 56 patients (80%). The most common identified organism was Streptococcus sp (n = 19). Visual acuity at last follow-up was 20/400 or better in 19 patients (27.1%). Three patients underwent evisceration or enucleation (4.3%). Last recorded postoperative VA (mean LogMAR 1.99 ± 0.94, Snellen VA equivalent finger count) improved from presenting VA (mean LogMAR 2.37 ± 0.38, Snellen VA hand motions) (P ≤ 0.001). There was no statistically significant correlation between the underlying etiology or the timing of surgery with this VA outcome. CONCLUSION:: Although less than one-third of patients achieved 20/400 or better VA, this VA often improved significantly from presenting VA.

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