ABSTRACT
PRCIS: Bleb-related endophthalmitis (BRE) is a serious complication of glaucoma filtration surgery. The current study reports similar visual and intraocular pressure (IOP) outcomes in eyes treated with pars plana vitrectomy (PPV) compared with vitreous biopsy and injection of intravitreal antibiotics (TI). PURPOSE: The purpose of this study was to investigate the isolated organisms, visual acuity (VA), and IOP outcomes associated with delayed-onset BRE in eyes treated with PPV versus TI. PATIENTS AND METHODS: A retrospective chart review was conducted at the Bascom Palmer Eye Institute (Miami, Florida) and the University of Florida (Gainesville, FL) identifying patients treated for BRE with at least 1 month of follow-up from the inception of an electronic health record (2014 and 2011, respectively) through 2021. All patients had undergone bleb-forming glaucoma surgery at least 1 month before endophthalmitis diagnosis. RESULTS: Thirty-nine eyes from 39 patients (33 from Bascom Palmer, 6 from University of Florida) were included. Trabeculectomy was performed in 34 of 39 eyes (87.2%). Streptococcus species (9 eyes, 23.1%) and Staphylococcus species (8 eyes, 20.5%) were the most common isolated organisms and were similar in both treatment groups ( P =0.49). Baseline VA was worse in the PPV group (logarithm of the minimum angle of resolution: 2.51 vs. 2.16, P =0.04), but VA at last follow-up was similar ( P =0.48) in both groups. After recovery from BRE, the average IOP in the PPV group was 15.1 mm Hg on 0.9 IOP-lowering medications compared with 12.6 mm Hg on 1.2 medications in the TI group (IOP: P =0.56; medications: P =0.80). Additional glaucoma surgery was performed in 44.4% of the PPV eyes and 16.7% of the TI eyes ( P =0.09). CONCLUSION: In eyes with delayed-onset BRE, isolated organisms, visual outcomes, and IOP control were similar after initial PPV compared with TI.
Subject(s)
Endophthalmitis , Eye Infections, Bacterial , Glaucoma , Humans , Biopsy/adverse effects , Endophthalmitis/diagnosis , Endophthalmitis/drug therapy , Endophthalmitis/etiology , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/etiology , Glaucoma/complications , Glaucoma/diagnosis , Glaucoma/surgery , Intraocular Pressure , Retrospective Studies , Vitrectomy/adverse effectsABSTRACT
PURPOSE: Dexamethasone intravitreal corticosteroid implants (OZURDEX) have been used to treat subretinal fluid associated with several retinal diseases. We describe the use of a dexamethasone intravitreal implant for symptomatic management in a case of X-linked (juvenile) retinoschisis (XLRS). METHODS: A 19-year-old man diagnosed with XLRS was treated with a dexamethasone intravitreal implant for his newly symptomatic subretinal fluid. CONCLUSION: Dexamethasone intravitreal implant treatment in the setting of XLRS has not been previously described. To the authors' knowledge, this is the first description of the use of corticosteroid implants to treat symptomatic subretinal fluid in XLRS. Further studies are warranted to investigate the role of corticosteroid implant treatment in XLRS.
Subject(s)
Dexamethasone/administration & dosage , Retinoschisis/drug therapy , Visual Acuity , Drug Implants , Follow-Up Studies , Glucocorticoids/administration & dosage , Humans , Intravitreal Injections , Male , Retina/pathology , Retinoschisis/diagnosis , Retinoschisis/physiopathology , Tomography, Optical Coherence , Young AdultABSTRACT
We report a case of central serous chorioretinopathy (CSC) that developed 1 month after an intralesional injection of triamcinolone acetonide that was administered during removal of a chalazion. The subretinal fluid and ipsilateral visual acuity (VA) worsened with initial observation. The edema resolved with verteporfin photodynamic therapy (PDT) 1 month after diagnosis, but VA did not improve during short-term follow-up. We conclude that CSC can occur as a complication of low-dose intrapalpebral corticosteroid administration and provide another example of the therapeutic role of PDT in the management of this disease.
