eprintid: 24460
rev_number: 11
eprint_status: archive
userid: 1589
dir: disk0/00/02/44/60
datestamp: 2018-05-30 09:41:09
lastmod: 2024-07-26 21:58:25
status_changed: 2018-05-30 09:41:09
type: article
metadata_visibility: show
creators_name: Zapp, Daniel
creators_name: Loos, Daria
creators_name: Feucht, Nikolaus
creators_name: Khoramnia, Ramin
creators_name: Tandogan, Tamer
creators_name: Reznicek, Lukas
creators_name: Mayer, Christian
title: Microbial keratitis-induced endophthalmitis: incidence, symptoms, therapy, visual prognosis and outcomes
subjects: ddc-610
divisions: i-910900
abstract: Background: To evaluate symptoms, therapies and outcomes in rare microbial keratitis-induced endophthalmitis.

Methods: Retrospective study with 11 patients treated between 2009 and 2014. Clinical findings, corneal diseases, history of steroids and trauma, use of contact lenses, number and type of surgical interventions, determination of causative organisms and visual acuity (VA) were evaluated.

Results: The incidence of transformation from microbial keratitis to an endophthalmitis was 0.29% (n = 11/3773). In 90.9% (n = 10/11), there were pre-existent eyelid and corneal problems, in 45.5% (n = 5/11) rubeosis iridis with increased intraocular pressure and corneal decompensation, and in 18.2% (n = 2/11), ocular trauma. Specimens could be obtained in 10 of 11 samples: 33.3% of those 10 specimens were Gram-positive coagulase-negative Staphylococci (n = 3/10) or Gram-negative rods (n = 3/10) and 10.0% Staphylococcus aureus (n = 1/10). In 30% (n = 3/10), no pathogens were identifiable. 72.7% (n = 8/11) of all keratitis-induced endophthalmitis were treated with vitrectomy and 9.1% (n = 1/11) with amniotic-membrane transplantation. In 27.3% (n = 3/11) the infected eye had to be enucleated – 18.2% (n = 2/11) primarily, 9.1% (n = 1/11) secondarily. No patient suffered from sympathetic ophthalmia. The median initial VA was 2.1 logMAR (n = 11/11). At one month, median VA was 2.0 logMAR (n = 7/11), after three months 2.0 logMAR (n = 6/11), and after one year 2.05 logMAR (n = 6/11). The change in VA was not significant (p > 0.99). 36.4% (n = 4/11) of the cases resulted in blindness.

Conclusions: The overall outcome is poor. Enucleation should be weighed against the risk of local and systemic spread of the infection, prolonged rehabilitation and sympathetic ophthalmia.
date: 2018
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1653439041
own_urn: urn:nbn:de:bsz:16-heidok-244606
language: eng
bibsort: ZAPPDANIELMICROBIALK2018
full_text_status: public
publication: BMC Ophthalmology
volume: 18
number: 112
place_of_pub: London
pagerange: 1-7
issn: 1471-2415
citation:   Zapp, Daniel ; Loos, Daria ; Feucht, Nikolaus ; Khoramnia, Ramin ; Tandogan, Tamer ; Reznicek, Lukas ; Mayer, Christian  (2018) Microbial keratitis-induced endophthalmitis: incidence, symptoms, therapy, visual prognosis and outcomes.  BMC Ophthalmology, 18 (112).  pp. 1-7.  ISSN 1471-2415     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/24460/1/12886_2018_Article_777.pdf