Rhegmatogenous Retinal Detachment in the Setting of Endophthalmitis: Risk Factors and Visual Outcomes

Abstract

BACKGROUND AND OBJECTIVE: To investigate risk factors for rhegmatogenous retinal detachment (RRD) and visual acuity (VA) in eyes with RRD after developing endophthalmitis. PATIENTS AND METHODS: Retrospective comparative study of 133 eyes with endophthalmitis at a tertiary center between 2009 and 2018. Demographics, exam findings, interventions, and outcomes were assessed. Cases of RRD within 6 months after onset of endophthalmitis were further analyzed. RESULTS: Seventeen eyes (12.7%) with endophthalmitis developed RRD. Endogenous etiology was associated with higher rate of RRD ( P = .038). Eyes that developed RRD had worse VA (20/3271) at 6 months (20/236; P = .001). Excluding the six eyes with macula-off RRD, VA for the remaining 11 eyes that developed RRD (20/1213) was similar to those without RRD (20/236; P = .095). CONCLUSIONS: Endogenous etiology of endophthalmitis was associated with a higher rate of RRD. Eyes with successful RRD repair had outcomes similar to eyes that did not develop RRD. [ Ophthalmic Surg Lasers Imaging Retina . 2021;52:257–262.]

Anatomical and Functional Outcomes in Delayed Onset versus Concurrent Retinal Detachment in Endophthalmitis

“…14 In groups 1 and 2 of our study, VA improved in 26 patients (34.21%) and 16 patients (35.55%), respectively. Although there was no statistically significant difference between the two, the final VA in group 1 (20/1291) was noted to 12 The majority of detachments in both groups in this study were noted to be due to atrophic holes. This reemphasizes the importance of a thorough peripheral retinal evaluation in follow-up cases with endophthalmitis and during the primary vitrectomy itself, if possible.…”

“…Previous studies have reported a bimodal peak with two predominant presentations in either the third decade or the sixth decade. 3,6,[9][10][11][12] The etiology of endophthalmitis in both of our groups was found to be exogenous in >80% of the study patients. While cataract surgery and trauma was noted as the most common etiology for exogenous endophthalmitis in group 1, cataract surgery alone was the predominant etiology in group 2.…”

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…”

“…8 This trend was however not supported in the more recent prospective study by Chiquet et al 6 Nelsen et al 9 reported that postoperative causes of endophthalmitis were most frequently complicated by RD. Som et al, and Dave et al however, found that posttraumatic causes were the most frequent, 7,10 and Lee et al, 11 contrarily, found that endogenous etiology was associated with a higher rate of RD. Finally, in the EVS, management of the endophthalmitis by pars plana vitrectomy (PPV) or tap-and-inject did not change the rate of subsequent RD.…”