Purpose: Exogenous endophthalmitis (ExE) results from microbial infection as a complication of ocular surgery, penetrating ocular trauma, and intraocular foreign bodies. We herein review the classification of ExE, etiological agents, differential diagnosis and therapeutic challenges.
Methods: Narrative Literature Review.
Results: Identification of the causative agent through ocular fluid analysis is central in the diagnostic work-up of ExE. Prompt intravitreal antimicrobial therapy is key to successful management of ExE and vitrectomy is essential in severe cases. In culture-negative cases, and in the presence of specific features, a diagnosis of sterile intraocular inflammation or toxic syndrome should be suspected.
Conclusion: Strict adherence to treatment guidelines may improve outcomes of ExE, however the ultimate prognosis, especially in severe cases, may depend more on the virulence of the causative organism and associated ocular complications. Accurate differential diagnosis and effective treatment are crucial elements in the management and prognosis of non-infectious masquerades of ExE.
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| http://dx.doi.org/10.1080/09273948.2022.2152699 | DOI Listing |
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Article Synopsis
- A study analyzed the effects and complications of immediate small-gauge pars plana vitrectomy on 107 patients with exogenous endophthalmitis from 2016 to 2022.
- Results showed significant improvement in best-corrected visual acuity (BCVA) from initial diagnosis to follow-up, with a mean logMAR BCVA change from 2.26 to 1.21.
- Common complications included retinal detachment (17.8%) and secondary glaucoma (9.3%), highlighting the need for patient counseling on the risks of the surgery.
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