Predictors of visual outcome and the role of early vitrectomy in streptococcal endophthalmitis

Kurniawan, Emil D; Rocke, John R; Sandhu, Sukhpal S.; Allen, Penelope J

doi:10.1111/ceo.13077

Cited by 32 publications

(36 citation statements)

References 23 publications

(56 reference statements)

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“…Despite aggressive treatment of the infection, visual outcomes are generally poor. 1 – 9 Kuriyan et al 8 studied 63 cases of streptococcus endophthalmitis over an 11-year period and found that the most common clinical settings were bleb-associated (27%), after intravitreal injection (25%) and after cataract surgery (21%). All patients received intravitreal antibiotics and 22% of the patients underwent pars plana vitrectomy (PPV).…”

Section: Introductionmentioning

confidence: 99%

“…Visual outcomes were generally poor with only 25% having best-corrected visual acuity (BCVA) of 20/400 or better and 25% of the patients had their eyes removed by operations, either evisceration or enucleation. 8 Kurniawan et al 9 studied 101 cases of streptococcus endophthalmitis over a 15-year period and found that 87.1% of the infection occurred postoperatively, and cataract surgery was the most commonly performed operation. Almost all patients had initial intravitreal antibiotics, and 30.7% of the patients underwent vitrectomy.…”

Section: Introductionmentioning

confidence: 99%

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Predictive factors in the treatment of streptococcal endophthalmitis

Yospaiboon¹,

Meethongkam²,

Sinawat³

et al. 2018

OPTH

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ObjectiveTo evaluate visual outcomes and possible predictive factors in the treatment of infectious endophthalmitis caused by Streptococcus species during 2012–2016 at a large referral eye center in northeastern Thailand.MethodsA retrospective medical record chart review of patients with culture-positive endophthalmitis caused by Streptococcus species was conducted. Demographic data including age, gender, occupation, duration of symptoms, time to surgery, surgical procedures, initial visual acuity at presentation, and final visual acuity after treatment were collected and analyzed. Possible predictive factors associated with improved visual outcomes were also studied.ResultsForty-five eyes of 45 patients were recruited for the study. The 3 most common types of endophthalmitis were postoperative (35.56%), posttraumatic (20%), and endogenous (15.56%). At presentation, most patients (95.56%) had visual acuity of hand motion (55.56%), light perception (28.89%), or no light perception (11.11%). The 3 most common isolates were Streptococcus pneumoniae (44.44%), Group B β-hemolytic Streptococcus (26.68%), and Streptococcus viridans (20%). Most patients (62.22%) were treated with surgical interventions, either pars plana vitrectomy with intravitreal antibiotics or pars plana vitrectomy with intravitreal antibiotics and silicone oil tamponade. After treatment, improved visual outcome was noted in only 9 patients (20%), and no visual improvement was seen in 36 patients (80%). Evisceration and enucleation were performed in 15 patients (33.33%). The only possible predictive factor associated with improved visual outcomes was early vitrectomy, performed within 3 days.ConclusionStreptococcal endophthalmitis is often associated with poor visual prognosis. Only 9 patients (20%) had improved vision after treatment. The only possible predictive factor associated with improved visual outcomes was vitrectomy within 3 days. Early diagnosis and early vitrectomy are therefore recommended.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictive factors in the treatment of streptococcal endophthalmitis

Yospaiboon¹,

Meethongkam²,

Sinawat³

et al. 2018

OPTH

View full text Add to dashboard Cite

show abstract

“…We read the article by Kurniawan et al . with interest, however, we believe that it deserves further discussion.…”

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confidence: 90%