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Twenty years of endophthalmitis: Incidence, aetiology and clinical outcome
Author(s) -
Malmin Agni,
Syre Heidi,
Ushakova Anastasia,
Utheim Tor Paaske,
Forsaa Vegard Asgeir
Publication year - 2021
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14511
Subject(s) - medicine , endophthalmitis , incidence (geometry) , etiology , surgery , retrospective cohort study , keratitis , ophthalmology , diabetic retinopathy , diabetes mellitus , endocrinology , physics , optics
Purpose To review the incidence, aetiology and outcomes of endophthalmitis during a 20‐year period in a Norwegian university hospital. Methods Single‐centre retrospective review. Medical records of all patients admitted to Stavanger University Hospital with suspected endophthalmitis between January 1999 and December 2018 were reviewed. Results We identified 84 eyes of 81 patients. Postoperative endophthalmitis (PE) was seen in 64 eyes (76%), endogenous endophthalmitis in thirteen eyes (15%), trauma in four eyes (5%) and three eyes (4%) had keratitis‐associated endophthalmitis. Administration of intravitreal injections (IVI) was the most common cause (30%), followed by cataract surgery (CS) (21%). Of 40238 IVI, 23 PE cases were identified (incidence, 0.057%; 95% confidence interval [CI] 0.036–0.086%). Of 39697 CS, 12 PE cases were identified (incidence, 0.030%; 95%CI 0.016–0.053%). After introduction of intracameral cefuroxime PE incidence after CS decreased from 0.10% in 1999–2003 to 0.015% in 2004–2018 (p = 0.003). Eighty‐four per cent of organisms were Gram‐positive. Coagulase‐negative staphylococci accounted for 54% of culture‐proven cases, and 89% of post‐IVI culture‐proven cases. Thirty eyes (36%) either regained their previous vision or lost ≤1 Early Treatment Diabetic Retinopathy Study line. One third of endophthalmitis cases had a favourable visual outcome of logMAR 0.2 or better. Conclusion PE after IVI occurred in 1 in 1750 procedures, and was the most common cause of PE. The incidence of PE after CS has decreased >sixfold since 2003, to 1 in 6700 surgeries. A high proportion of low‐virulence bacterial species may have contributed to the favourable visual outcome.