J Korean Ophthalmol Soc.  2021 Oct;62(10):1381-1387. 10.3341/jkos.2021.62.10.1381.

Characteristics and Outcomes of Endogenous Endophthalmitis in Patients with Long-term Steroid Use

• Chae WJ
• Lee SW

• KMID: 2521640
• DOI: http://doi.org/10.3341/jkos.2021.62.10.1381

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.

Keyword

Endophthalmitis, Sepsis, Steroid