Longitudinal study of retinal status using optical coherence tomography after acute onset endophthalmitis following cataract surgery

Zhou, Thierry; Aptel, Florent; Bron, A.; Palombi, Karine; Thuret, Gilles; Rouberol, F.; Creuzot‐Garcher, Catherine; Chiquet, Christophe

doi:10.1136/bjophthalmol-2016-309542

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…ISe disruption has been reported after endophthalmitis in previous studies 14,32 and was noted in 49% of the eyes in our cohort. The presence of ISe disruption was associated with worse visual acuity.…”

Section: Discussionsupporting

confidence: 77%

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Atrophy of retinal inner layers is associated with poor vision after endophthalmitis: a spectral domain optical coherence tomography study

Chen

et al. 2017

Eye

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PurposeTo investigate the retinal structural changes in endophthalmitis and their association with visual outcome.Patients and methodsForty-five eyes of 45 patients diagnosed with endophthalmitis were included. Spectral domain optical coherence tomography (SD-OCT) was performed after inflammation was controlled. The relationship between SD-OCT features and best-corrected visual acuity (BCVA) at the last follow-up was analyzed.ResultsThe structural changes included inner segment ellipsoid (ISe) disruption (49%), atrophy of retinal inner layers (24%), epimacular membrane (24%), and macular edema (24%). BCVA was worse in patients with ISe disruption (P=0.005) and retinal inner layers' atrophy (P=0.004) compared with those without. There was no significant difference of BCVA between the patients with and without epimacular membrane, or intraretinal cysts. Multivariate regression showed that atrophy of retinal inner layers (b=0.41±0.17, P=0.022) was the only independent factor associated with BCVA.ConclusionAtrophy of retinal inner layers is associated with visual impairment in endophthalmitis, despite successful management.

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Section: Discussionsupporting

confidence: 77%

“…26 Epimacular membrane and intraretinal cysts had been reported as morphological changes after endophthalmitis. 14,15,17,32 However, these morphological changes were not associated with visual impairment in our case series.…”

Section: Discussioncontrasting

confidence: 48%

Atrophy of retinal inner layers is associated with poor vision after endophthalmitis: a spectral domain optical coherence tomography study

Chen

et al. 2017

Eye

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“…The term "endophthalmitis maculopathy" was introduced by Morris, Kuhn et al in 1995, 17 but OCT technology has improved our understanding of this concept, highlighting both reversible (edema, epimacular proliferation) and irreversible (atrophic) macular pathology long after endophthalmitis resolution. 26 This is not surprising, as complete vitrectomy frequently reveals pus and inflammatory debris adhering to the surface of the macula (macular hypopyon, Supplementary Video 1). 17 Further studies are needed to better characterize endophthalmitis maculopathy, both anatomically and functionally, with OCT, angiography, microperimetry, and electroretinography.…”

Section: Discussionmentioning

confidence: 94%

<p>Complete and Early Vitrectomy for Endophthalmitis After Cataract Surgery: An Alternative Treatment Paradigm</p>

Dib¹,

Morris²,

Oltmanns³

et al. 2020

OPTH

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In this study, we report the treatment outcomes of complete and early vitrectomy for endophthalmitis (CEVE) after cataract surgery as the predominate initial treatment, accompanied by systemic antibiotics and retreatment of persistent or recurrent purulence (CEVE+). Patients and Methods: Clinical features and microbiological factors were retrospectively reviewed in 62 eyes of 62 patients who were treated for acute postcataract endophthalmitis (APCE) occurring within three weeks of cataract surgery at Retina Specialists of Alabama, between 2007 and 2017. Results: Visual acuity on presentation included light perception (LP) in 18 eyes (29%) and hand motion (HM) in 23 eyes (37%). Initial treatment was maximum possible vitrectomy in 48 eyes (77%) and tap-and-inject in 14 eyes (23%), with 38 eyes (61%) receiving two or more treatments. Cultures for the first intervention were positive in 49 eyes (79%) and virulent in 18 eyes (29%). At a median follow-up time of five months, final visual acuity was ≥20/40 in 49 eyes (79%), between 20/50 and 5/200 in seven eyes (11%), and <5/200 in six eyes (10%). Virulence was the strongest predictor of poor visual outcome. Retinal detachment occurred in four eyes (6%), likely from necrotic retinal defects in each case. Conclusion: Complete and early vitrectomy is a safe and effective initial treatment for APCE. When accompanied by systemic antibiotics and retreatment (CEVE+) of recurrent media opacification, it improves recovery of 20/40 or better visual acuity by approximately 50% compared to a predominantly tap-and-inject treatment paradigm. We recommend CEVE for fundus-obscuring APCE (~75% of all cases) whenever the view is inadequate to rule out macular distress.

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“…In this case, the ferroalloy metallic IOFB resulted in retinal thinning, which could have occurred as follows: first, the IOFB could have caused undetected bacterial or viral infection resulting in endophthalmitis, which could have caused retinal and choroidal ischemia, leading to macular atrophy. According to a previous study, macular atrophy was reported in five of 46 patients with endophthalmitis [ 2 ]. Second, direct mechanical damage by an IOFB to the optic disc or adjacent retina could have reduced the retinal thickness and choroidal vasculature.…”

mentioning

confidence: 99%

Intraocular Foreign Body Causing Retinal and Choroidal Ischemia

Kim

Kang

2020

Korean J Ophthalmol

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Longitudinal study of retinal status using optical coherence tomography after acute onset endophthalmitis following cataract surgery

Abstract: ERM and ME were the main macular abnormalities diagnosed after 1 year of follow-up, associated with VA less than or equal to 20/40 in 50% of the cases. Ultrastructural abnormalities of the ELM and the ellipsoid band were frequently observed in those patients.

Cited by 6 publications

References 27 publications

Atrophy of retinal inner layers is associated with poor vision after endophthalmitis: a spectral domain optical coherence tomography study

Atrophy of retinal inner layers is associated with poor vision after endophthalmitis: a spectral domain optical coherence tomography study

<p>Complete and Early Vitrectomy for Endophthalmitis After Cataract Surgery: An Alternative Treatment Paradigm</p>

Intraocular Foreign Body Causing Retinal and Choroidal Ischemia

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