RETINAL DETACHMENT AFTER ENDOGENOUS ENDOPHTHALMITIS

PURPOSE: To assess factors associated with retinal detachment (RD) in eyes presenting with endogenous endophthalmitis (EE). METHODS: Multicenter retrospective study of individuals with an EE diagnosis from seven tertiary care centers. Demographics, medical history, ocular examination findings, microbial cultures (blood or intraocular), and management strategies were assessed relative to subsequent RD occurring within 6 months of EE diagnosis. Of note, this study did not distinguish between intraocular cultures without growth and eyes that were not sampled for an intraocular organism. RESULTS: A total of 201 eyes from 171 patients presented with EE. Of these, 22.4% (45/201) had a subsequent RD. Eyes that experienced a subsequent RD had worse presenting visual acuity ( P = 0.006) and lower intraocular pressure at presentation (RD: 13.7 ± 5.4 mmHg vs. No RD: 15.7 ± 6.5 mmHg, P = 0.04). Compared with other forms of bacteremia, S. aureus bacteremia was associated with increased odds of subsequent RD (OR: 6.10, CI: 1.82-20.41, P = 0.003). Eyes with a subsequent RD did not have significantly greater rates of therapeutic pars plana vitrectomy (RD: 11/48, 22.9% vs. No RD: 36/153, 23.5%). CONCLUSION: Eyes presenting with visual acuity ≤ light perception or S. aureus bacteremia had a higher risk of subsequent RD and may warrant closer surveillance. Although no therapeutic strategies were associated with reduced odds of subsequent RD, a pars plana vitrectomy was not associated with an increased risk of RD, suggesting that it may aid in eyes with lackluster responses to systemic and intravitreal pharmacotherapy.