, Nidhi Relhan Batra1, Stephen G. Schwartz2 and Andrzej Grzybowski3, 4
(1)
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
(2)
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, Florida, USA
(3)
Chair of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
(4)
Institute for Research in Ophthalmology, Poznan, Poland
In patients with endophthalmitis, the occurrence of rhegmatogenous retinal detachment (RD) is uncommon and is generally associated with poor visual outcomes. Management of such patients can pose a surgical challenge. While managing the endophthalmitis, RD can be identified at the time of presentation, during vitrectomy or in the postoperative time period. Indirect ophthalmoscopy, echography or direct visualization under microscope may confirm the diagnosis.
Frequency
Visual outcomes
Presentation
Risk factors associated with poor visual outcomes
Frequency : Retinal Detachment in Endophthalmitis
In the Endophthalmitis Vitrectomy Study (EVS), patients with RD at initial diagnosis of endophthalmitis were excluded. However, 35/420 (8.3%) patients overall developed RD during follow-up.
The rates of RD among group of patients undergoing vitrectomy, needle vitreous aspiration, and mechanical vitreous biopsy were 7.8, 11, and 8%, respectively.
Visual Outcomes : Retinal Detachment in Endophthalmitis
In the EVS patients with available data, final visual acuity 20/40 or better was reported in 8/30 (27%) patients with RD compared to 201/364 (55%) patients without RD.
The overall visual outcomes in this subgroup of the EVS were reported to be poor with more than half (16/30) patients with RD achieving visual acuity worse than 5/200 despite a high anatomic success rate of 78% (18/23).
Presentation : Retinal Detachment in Endophthalmitis
Patients with endophthalmitis and concurrent RD
Patients with endophthalmitis and delayed-onset RD
In the setting of endophthalmitis, RD developing after vitrectomy surgery has been reported to range from 4.6 to 16% (1, 5–7) (compared to 5% in vitrectomy performed for non-endophthalmitis cases 1, 5, 6).
Risk Factors Associated with Poor Visual Outcomes in Eyes with RD and Endophthalmitis
RD associated with endophthalmitis is associated with generally poor anatomic and visual outcomes. Following are the risk factors associated with poor visual outcomes:
Infection with more virulent organisms
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