Highlights: 10-Year Retrospective Study of Infectious Endophthalmitis At A Philippine Tertiary Hospital

  • A research was published on 14 August 2020 about the infectious endophthalmitis.
  • Endophthalmitis is a sight-threatening disease characterized by marked progressive inflammation of the vitreous and/or aqueous humors.
  • There is a lack information regarding endophthalmitis in the Philippines.
  • The study aimed to provide long-term summary data on endophthalmitis cases seen at the largest tertiary referral hospital in the Philippines.
  • The study included endophthalmitis-diagnosed patients at the Philippine General Hospital from January 1, 2007 to December 31, 2016.
  • Data pertaining to history, associated risk factors, isolated microorganisms, management, and final visual results for each patient were examined.
  • The study included 202 cases diagnosed within the audit period.
  • Post-traumatic endophthalmitis constitutes 55.94 percent of the cases which is the highest.
  • Suture-associated endophthalmitis constitutes 2.97 percent of the cases which is the lowest.
  • Males comprised 71.29 percent of the population.
  • The largest age-group affected was between 0 to 10 years old at 24.75 percent.
  • Predominant cause was Gram-positive bacteria at 38.18 percent.
  • The top three common microorganisms isolated were Streptococcus, Staphylococcus, and Pseudomonas.
  • Pars plana vitrectomy was done for 62.87 percent of patients.
  • Pars plana vitrectomy is a general term for a group of operations accomplished in the deeper part of the eye, all of which involve removing some or all of the vitreous humor—the eye’s clear internal jelly.
  • There was a higher proportion of post-traumatic endophthalmitis cases compared to traditional estimates but accordant with studies from China and Thailand.
  • The majority of these cases involved younger children as well as young to middle-aged males involved in carpentry and construction work.
  • The study suggests a need for increased public health awareness and strengthening of childcare and workplace safety policies.
  • Microbiologic profile showed a lower proportion of Gram-positive infections and a higher proportion of mixed pathogen infections compared to other studies.
  • There was also a higher proportion of fungi associated with post-operative and keratitis-induced endophthalmitis.
  • Post-operative endophthalmitis is defined as severe inflammation involving both the anterior and posterior segments of the eye after intraocular surgery.
  • Keratitis-induced endophthalmitis is a sight-threatening disease, often bearing the worst possible visual outcome.
  • The best outcomes were seen in acute post-operative and bleb-associated endophthalmitis.
  • Bleb‐associated endophthalmitis is a potentially vision‐threatening complication of trabeculectomy.
  • Trabeculectomy a surgical procedure used in the treatment of glaucoma to relieve intraocular pressure by removing part of the eye’s trabecular meshwork and adjacent structures.
  • The worst outcomes were seen in endogenous and keratitis-induced endophthalmitis.
  • Visual outcomes were poorer compared to other Western and Asian countries.
  • Only 21.7 percent of patients improved from presentation.

Source:

Dimacali, V.G., Lim Bon Siong, R. Infectious endophthalmitis at a Philippine tertiary hospital: a ten-year retrospective study. J Ophthal Inflamm Infect 10, 19 (2020). https://doi.org/10.1186/s12348-020-00208-0

https://en.wikipedia.org/wiki/Vitrectomy

https://emedicine.medscape.com/article/1201260-overview

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934862/#:~:text=Clinical%20image%20of%20microbial%20keratitis,endothelium%20precipitates%20on%20the%20cornea.

https://onlinelibrary.wiley.com/doi/full/10.1111/ceo.13477

https://en.wikipedia.org/wiki/Trabeculectomy


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