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Etiology, combined medical and surgical therapy and follow-up of endogenous endophthalmitis: A ten-year review
K. Zell, K. Engelmann
Introduction: From 1989 to 1998, 27 eyes from 25 patients with endoge- nous endophthalmitis were treated at the University Eye Hospital in Hamburg. The outcome of these patientes with respect to predisposing factors, infectious agents and therapies were investigated.
Methods: The data of these patients were collected retrospectivelly. Most patients were followed up in an average time of 12 months.
Results: All patients had at least one predisposing factor that may cause endogenous endophthalmitis. The most frequent factors were: malignancy (29.6%), diabetes mellitus (25.9%), intravenous drug-abuse (25.9%) and previous gastrointestinal operations (25.9%). 51.9% of the cases were caused by fungal agents most commonly Candida (78.5%). In 40.7% of the cases bacterial agents were responsible, most frequently Pseudomonas and Streptococcus sp each in 4 patients (36.4%).
All patients were systemically treated with antibiotics. In addition 17 patients (63.0%) recieved Amphotericin B systemically. Vitrectomy was performed in 85.2% of the patients.
At least 51.9% of the patients achieved a visual acuity of 20/400 or more with an average of 20/50. Only two patients (9.4%) underwent enucleation.
Conclusion: In this study a reasonable visual outcome in patients with endogenous endophthalmitis was achieved with a combination of medical and surgical therapy with only a small percentage requiring enucleation.
University Eye Hospital Hamburg, Martinistr. 52, D-20251 Hamburg