Endogenous Endophthalmitis - A Major Review

Ocul Immunol Inflamm. 2023 Sep;31(7):1362-1385. doi: 10.1080/09273948.2022.2126863. Epub 2022 Oct 28.

Abstract

Endogenous endophthalmitis (EE) is an uncommon but potentially devastating ocular infection involving the inner layers of the eye. The global incidence of EE is on the rise. Common ocular signs and symptoms associated with EE include conjunctival injection, ocular pain, and reduced visual acuity. On clinical examination, a history of prior or coexisting systemic infections, symptoms (e.g., fever, malaise), and localizing features may be noted. Clinical diagnosis is often challenging, resulting in critical delays that contribute to a poor prognosis. Blood cultures and ocular fluid samples can aid in conforming causative pathogen(s), after which empirical antibiotic therapy, both systemic and intravitreal, should be instated. The use of steroids to suppress inflammation remains controversial. Surgical options include pars plana vitrectomy. Overall prognosis varies depending on host and pathogen factors, and early diagnosis and initiation of appropriate treatment are crucial.

Keywords: Bacterial; blood culture; endogenous; endophthalmitis; fungal; microbiology.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Endophthalmitis* / diagnosis
  • Eye Infections, Fungal* / diagnosis
  • Humans
  • Retrospective Studies
  • Vitrectomy / methods
  • Vitreous Body

Substances

  • Anti-Bacterial Agents