Ultrasonographic findings in endophthalmitis

Abstract

Ultrasonographic findings are reported in 7 cases of endophthalmitis (6 of bacterial and 1 of fungal origin) resulting from perforating injuries (2 cases), severe corneal ulcers (2 cases) and open-eye surgery (3 cases). The most frequent ultrasonographic picture was characterized by a series of low reflectivity echoes in the vitreous with a high degree of mobility (7/7), fairly large endovitreal vacuoles (317) and hyaloid thickening (3/7). In one case the vitreous involvement was confined to only one quadrant. Choroidal thickening both of a homogeneous-diffuse (2/7) and nodular-multifocal type (3/7) was found. Localized choroidal detachment (1/7) and exudative pre-equatorial retinal detachment (1/7) were detected in only two cases. Ultrasonography proved useful both for detecting involvement of the posterior segment and for monitoring the time course of the infection process.

Reliability of Ocular Ultrasonography Findings for Pre-surgical Evaluation in Various Vitreo-retinal Disorders

“…18 In addition to the above, findings of dense vitreous opacities, retinal detachment, macular detachment, and choroidal detachment on USG are shown to be associated with poor visual outcome in endophthalmitis. [20][21][22][23][24] Potential limitations of our study include its retrospective nature and small number of eyes in each subgroup. In this study, we did not evaluate the nature of IOFB, the size of IOFB, and location of retinal tears.…”

Metastatic bacterial endophthalmitis

“…Echographically, changes were already marked, a finding at variance with the generally less serious ultrasonographic changes as reported by the above authors (Marchini et al 1995). For future cases this suggests that early serial assessment by ultrasound may be diagnostically helpful by demonstrating a rapid morphological sequence of events, unlikely to occur in non-infectious intraocular disease.…”

“…A morphological chaos was demonstrated in the vitreous space in all four patients, and compared to a recent clinical series including a literature review of ultrasonographic findings in endophthalmitis (Marchini et al 1995) our cases were, indeed, advanced. There was acoustical evidence of detached tunics and dense membranes, but no specific intraocular features to indicate bacterial infection.…”

Correlation between baseline echographic features of endophthalmitis, microbiological isolates, and visual outcomes

“…Moreover, the examinations are performed by different echography department technicians. Echographic pattern recognition is frequently difficult because of the rapidly changing anatomic patterns that may accompany endophthalmitis 4,5. In the current study, of 59 culture-negative patients for whom data were available, the mean interval between treatment and initial ultrasound was 0.8 days (median 0 days).…”

“…Further, it is often difficult to interpret echographic findings, because of the wide range of acoustic impedance mismatch within vitreous cavity tissues, dependent upon inflammatory reaction. Patterns seen during echographic examination range from barely visible, mildly reflective spot and dot-like images, to extensive, elaborate, and strongly reflective vitreous conglomerations appearing as veil-like sheets or curtains, which are almost “membranous” in form 4–6,11. In the current study, we graded the appearance of vitreous opacities (dense, moderate, mild, none) and membranes (marked, moderate, mild, none).…”