A Dual-Center Study of Retinal Detachment Following Endogenous Endophthalmitis.

PURPOSE: To evaluate factors associated with increased odds of retinal detachment (RD) following endogenous endophthalmitis (EE). METHODS: Retrospective study of individuals with EE from two tertiary care centers. Demographics, medical and ocular history, presenting clinical features, microbial cultures, and initial management were assessed in relation to subsequent RD. RESULTS: Of 93 study eyes, 30 (32.3%) diagnosed with EE developed subsequent RD. Compared with eyes that did not develop subsequent RD, eyes that developed RD had lower intraocular pressure (IOP) at presentation (RD: 14.0 ± 6.5 mm Hg vs. no RD: 17.3 ± 7.7 mm Hg, p = 0.02) and had higher rates of methicillin-resistant Staphylococcus aureus (MRSA) positive blood cultures (RD: (13/30) 43.3% vs no RD: (9/63) 14.3%, p = 0.004). The number of intravitreal injections was higher in eyes that developed subsequent RD compared to eyes that did not (RD: 5.3 ± 3.3 vs. no RD: 3.9 ± 3.0, p = 0.02), while no difference in subsequent RD was noted in eyes receiving therapeutic vitrectomy (p = 0.19). After controlling for age, sex, and duration of follow-up, lower IOP at presentation and MRSA positive blood cultures were associated with significantly higher odds of subsequent RD. CONCLUSION: Eyes with lower IOP at presentation and positive MRSA blood cultures were associated with higher rates of subsequent RD, even after controlling for age, sex, and duration of follow-up. Longer follow-up of patients with EE with MRSA bacteremia may be warranted, and larger cohort studies to identify additional features associated with RD are needed.

Duke Scholars

Author Sharon Fekrat Ophthalmology, Vitreoretinal Diseases & Surgery