Retinal Detachment After Endophthalmitis: Risk Factors and Outcomes

Abstract

Purpose To analyze the risk factors, clinical course, and visual and anatomic outcomes of retinal detachment (RD) after endophthalmitis. Patients and Methods This retrospective study included 108 patients diagnosed with endophthalmitis between August 2014 and May 2019 at a single tertiary referral center. Sixteen patients developed RD after endophthalmitis. Retrospective analysis was performed to compare the cohort of endophthalmitis alone versus the cohort that developed RD after endophthalmitis, with analysis of potential risk factors for RD after endophthalmitis and treatment outcomes. Results The incidence of RD after endophthalmitis was 14.8% (N=16/108). The median time to develop RD after endophthalmitis was 27 days (range: 1–581 days, IQR: 25.3). Thirteen (81.3%) cases of RD occurred less than 2 months after the diagnosis of endophthalmitis. The incidence of aphakia (p=0.023) and posterior synechia (PS) (p=0.014) were significantly higher in the RD group. The mean initial and final visual acuity (VA) of the endophthalmitis alone group was 1.9±0.8 logMAR and 1.2±1.0 logMAR (p<0.0001), respectively, and 1.9±0.9 logMAR and 1.3±1.2 logMAR (p=0.07) in the RD group, respectively. Enucleation or evisceration occurred in 31.3% of cases with RD after endophthalmitis. The rate of final retinal re-apposition for the RD cohort was 56.3%. Conclusion The anatomic and functional outcomes for RD after endophthalmitis remain poor, with significant risk for permanent vision loss. Aphakia and posterior synechiae were seen more often in cases with RD after endophthalmitis.

A Multicenter Review Evaluating the Risk of Rhegmatogenous Retinal Detachment Post Endophthalmitis

“…5 Chiquet et al, Wang et al, and Lee et al also did not report any relationship between organisms and RD rates. 6,11,20 In this review, 21 (66%) of the RD cases occurred within the first month after endophthalmitis diagnosis. This is comparable with the 56% in the investigation of Chiquet et al The rate of RD managed surgically was 94%, similar to that in Chiquet et al (93%) yet higher than in EVS (44%).…”

“…5 Chiquet et al, Wang et al, and Lee et al also did not report any relationship between organisms and RD rates. 6,11,20…”

Visual outcome of endogenous endophthalmitis in Thailand

“…The rate of RRD at presentation including development of RRD within 14 days after initial presentation were 8 patients (9 eyes, 22.5%). From previous reports, rate of RRD in endogenous endophthalmitis varied from 4.9% to 26.67% 4 , 15 – 18 . Virulence of organism and diabetes were previously reported as possible risk factors of developing RRD in exogenous endophthalmitis 19 , 20 .…”

“…Wang et al . reported that aphakia and presence of posterior synechiae were associated with the development of RD, but they included both exogenous and endogenous endophthalmitis in their study 15 . In our study, 7 of 16 eyes (43.75%) which developed RRD had hypopyon at presentation and 6 of 15 patients (40%) had diabetes.…”

Severe Retinal Necrosis Due to Klebsiella pneumoniae After Acute Prostatitis

“…In the late phase, contractile membranes may form on the surface of the retina. Both retinal necrosis and membrane proliferation can produce multiple retinal breaks and defects that may lead to retinal detachment [ 31 , 32 ]. A similar process occurs in acute retinal necrosis, in which retinal detachment has been described in up to 75% of eyes within 3 months of the onset of symptoms [ 33 , 34 ].…”