Risk Factors Leading to Enucleation or Evisceration in Infectious Endophthalmitis

Abstract

Endophthalmitis treatment consists of intravitreal antibiotics injections and, in selected circumstances, pars plana vitrectomy. However, severe or refractory cases may require an enucleation or evisceration (ENEV). Our study seeks to identify risk factors leading to enucleation or evisceration in patients with infectious endophthalmitis. A retrospective chart review of subjects with a clinical diagnosis of infectious endophthalmitis was undertaken. The affected eyes were stratified into groups: those that underwent ENEV and those in which the eyeball was preserved (EP). The groups were compared using statistical analyses. In total, 69 eyes diagnosed with infectious endophthalmitis were included in the study. There was a higher frequency of exogenous infectious endophthalmitis in the ENEV group versus the EP group. Postsurgical infectious endophthalmitis was lower in the ENEV than in the EP group. A visual acuity of no light perception was more common in the ENEV compared to the EP group. Panophthalmitis was more frequent in the ENEV versus the EP group. Our findings suggest that eyes with endophthalmitis presenting with a visual acuity of no light perception, panophthalmitis, or exogenous etiology have a higher risk of requiring ENEV. In addition, eyes with a postsurgical etiology may be at a lower risk of requiring ENEV.

True Eye Emergencies

“…(Sen HN, 2022), (Grzybowski et al, 2020)Additionally, in accordance with EVS, the use of systemic antibiotics may be considered in patients with severe signs, including panophthalmitis, early light perception (LP) vision, extensive hypopyon, or loss of fundus reflexes. The study results also found that cases of endophthalmitis with initial no light perception (NLP), panophthalmitis, or ecogenic causes did not receive intravitreal antibiotics but had a higher risk of enucleation/evisceration (Lugo Merly et al, 2022).…”