Background/aims This is the first nationwide prospective study to investigate the incidence and risk factors of endophthalmitis following pars plana vitrectomy (PPV). Methods This was a prospective, nationwide casecontrol study. Cases of presumed infectious endophthalmitis within 6 weeks of PPV were reported via the established British Ophthalmological Surveillance Unit. The surveillance period was 2 years. Controls (patients who had PPV but no endophthalmitis) were recruited from nine randomly selected UK centres. Results 37 reports were received and 28 cases met the diagnostic criteria for presumed infectious endophthalmitis following PPV. The incidence of endophthalmitis following PPV was 28 cases per 48 433 PPVs (1 in 1730 with a 95% CI of 1 in 1263 to 1 in 2747). 272 controls were randomly recruited from nine UK centres. Smaller gauge port sizes were not found to be a risk. Immunosuppression (OR 19.0, p=0.001) and preoperative topical steroids (OR 131.4, p<0.001) increased the endophthalmitis risk. Operating for retinal detachment was associated with a reduced risk of endophthalmitis (OR 0.10, p=0.005). Conclusions Endophthalmitis following PPV is rare. Operating with smaller gauge port sizes does not increase the risk of endophthalmitis.
This study helps surgeons promptly identify cases of endophthalmitis following vitrectomy and informs them about the various management options currently used and the likely outcome of this devastating complication.
Purpose To compare choroidal thickness in patients with regressed retinopathy of prematurity (ROP) with healthy controls using enhanced depth imaging optical coherence tomography (EDI OCT) Methods Twenty-four children and young adults (41 eyes) with regressed ROPZstage 3 had undergone EDI OCT with Spectralis FD-OCT as part of their clinical record. Their refraction, best-corrected visual acuity, and ophthalmoscopic findings were recorded. Corresponding data was collected prospectively from 33 healthy controls (58 eyes) who had been born at term. Choroidal thickness was measured independently by two observers subfoveally and at 1500 mm nasal and temporal to the fovea using EDI OCT. Results Mean subfoveal choroidal thickness, adjusted for refraction, was 271.1 mm (95% CI, 247.8-294.5) in the ex-ROP group, which was significantly thinner than 327.4 mm (95% CI, 293.8-360.9) in controls (P ¼ 0.008). Similarly, mean adjusted temporal choroidal thickness was 257.2 mm (95% CI, 240.2-274.2) in ex-ROP's vs 320.5 mm (95% CI, 288.6-352.3) in controls (P ¼ 0.001). There was no statistically significant difference in the nasal measurement. In the ex-ROP group, there was no significant correlation between subfoveal choroidal thickness and gestational age (r s ¼ 0.16, P ¼ 0.46) or birthweight (r s ¼ 0.03, P ¼ 0.90). In eyes without copathology in addition to regressed ROP (29 eyes, 19 patients), there was no significant correlation between subfoveal choroidal thickness and visual acuity. Conclusions Our findings of thinner subfoveal and temporal macular choroidal thickness in regressed ROP support the case for choroidal involvement in the pathogenesis of this condition.
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