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The following is a summary of “Impact of microorganism virulence on endophthalmitis outcomes,” published in the September 2024 issue of Ophthalmology by Yap et al.

Researchers conducted a retrospective study to evaluate how microorganism virulence affects visual outcomes in endophthalmitis. 

They conducted a retrospective, multicenter cohort study of patients with endophthalmitis from 2006 to 2021. A literature review helped analyze the cultured microorganisms into low and high-virulence groups. 

The results showed that 610 eyes with endophthalmitis were studied, with a median age of 69.4 years. Median visual acuity was hand movements at presentations and 20/120 at follow-up. Severe visual loss (≤20/200) occurred in 237 eyes (38.9%). The culture-positive rate was 48.5% (296 eyes). Highly virulent microorganisms were linked to a 4.48 OR for severe visual loss (P<0.001) and a 1.90 OR for retinal detachment or the need for enucleation (P=0.028). Oral flora was witnessed in 76 eyes (25.7%), and highly virulent microorganisms were observed in 68 eyes (22.9%). Highly virulent microorganisms were prevalent following glaucoma surgery (15 eyes, 34.9%) and vitrectomy (5 eyes, 35.7%) compared to intravitreal injections (2 eyes, 2.9%) and cataract surgery (22 eyes, 24.2%). Multivariate analysis revealed that the following factors were associated with poorer visual outcomes, poor presenting vision (P<0.001), glaucoma surgery (P<0.050), trauma (P<0.001), oral microorganisms (P<0.001), and highly virulent microorganisms (P<0.001) were associated with worse visual outcomes. 

Investigators concluded that the study classified microorganisms into high and low virulence categories, showing that highly virulent microorganisms were linked to worse visual outcomes and a higher chance of retinal detachment and enucleation.

Source: bjo.bmj.com/content/early/2024/09/18/bjo-2024-325605