Characteristics and Outcomes of Endogenous Endophthalmitis in Patients with Long-term Steroid Use
10.3341/jkos.2021.62.10.1381
- Author:
Woo Jung CHAE
1
;
Seung Woo LEE
Author Information
1. Department of Opthalmology, Dongguk University College of Medicine, Gyeongju, Korea
- Publication Type:Original Article
- From:Journal of the Korean Ophthalmological Society
2021;62(10):1381-1387
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose:To investigate the clinical characteristics and treatment outcomes of endogenous endophthalmitis (EE) in patients with a history of long-term oral corticosteroid (LTOC) use.
Methods:This study was a retrospective review of the medical records of 17 patients (20 eyes) who were diagnosed and treated for EE from LTOC use from March 2004 to December 2019.
Results:The mean age of the patients was 70.0 years, and 58.8% were men. Bilateral involvement was observed in three patients (17.6%). Predisposing medical conditions for steroid use were arthritis (6, 35.3%), renal disease (5, 29.4%), lung disease (5, 29.4%), and dermatologic disease (1, 5.9%). The most common causative agents were Gram-positive organisms (60.0%). All patients were treated with systemic antibiotics and vitreous tapping with intravitreal antibiotics or antifungal injection. Pars plana vitrectomy with intravitreal injection of antibiotics was performed in 11 eyes (55.0%). The initial best-corrected visual acuity (BCVA) of 20 eyes was 1.83 ± 0.79 and final BCVA was 0.70 ± 0.98 (p < 0.001). We analyzed the correlation between final visual acuity and initial visual acuity, causative organisms, sepsis, and vitrectomy. The results indicated a poor visual acuity prognosis for the patient group with sepsis.
Conclusions:Our study revealed that LTOCs can induce EE. Gram-positive bacteria were the most common causative organisms of EE from LTOC use. The patient group with sepsis showed a worse visual acuity prognosis than the other groups.
