Four late-onset endophthalmitis due to Streptococcus species following trabeculectomy

Conclusion: Streptococcus species, which is a frequently isolated agent after trabeculectomy, causes late-onset endophthalmitis, which has a poor VA prognosis and retinal condition.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: To report 4 late-onset endophthalmitis cases after trabeculectomy.

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Key Findings & Data:Case Report: Four patients (average age 51.5±33) who underwent surgery before 3-487 months (ave.135 months) and presented to our clinic between March 2003 and November 2004 with decreased visual acuity (VA), hyperemia and pain for 1-3 (ave. 1.75) days, were diagnosed as endophthalmitis.

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Conclusion & Impact:Conclusion: Streptococcus species, which is a frequently isolated agent after trabeculectomy, causes late-onset endophthalmitis, which has a poor VA prognosis and retinal condition.

🔬Design:Research Article

📍Scope:2003 Verileri

⚙️Variables:Endoftalmit · Streptococcus · Trabekülektomi

Abstract

Objective: To report 4 late-onset endophthalmitis cases after trabeculectomy. Case Report: Four patients (average age 51.5±33) who underwent surgery before 3-487 months (ave.135 months) and presented to our clinic between March 2003 and November 2004 with decreased visual acuity (VA), hyperemia and pain for 1-3 (ave. 1.75) days, were diagnosed as endophthalmitis. Although the patients presented to our clinic immediately after the symptoms appeared, the VA’s were light perception (LP) in 3 cases and hand-motion (HM) in 1 case. All cases underwent pars plana vitrectomy (PPV) and intravitreal antibiotic injection. Streptococcus pneumoniae in 2 cases and Streptococcus pyogenes in 2 cases were detected in specimens which were obtained from the vitreous. Best corrected visual acuity (BCVA) after an average 2 month (1-4 month) follow-up were no-LP in 1 case, LP in 1 case, and HM in 2 cases. Mean intraocular pressure (IOP) was 10±3.6 mm Hg. Even though B-Scan ultrasonography of the 4 eyes demonstrated membrane-like echoes in the vitreous cavity with an attached retina at presentation to the clinic, 2 (50%) of the patients had total retinal detachment and the other one had an optic atrophy at their last follow-up. Conclusion: Streptococcus species, which is a frequently isolated agent after trabeculectomy, causes late-onset endophthalmitis, which has a poor VA prognosis and retinal condition.

Özet

Amaç: Trabekülektomi sonrası Streptokoklara bağlı gelişen 4 geç endoftalmi olgusunu sunmak. Olgu Sunumu: Mart 2003 ve Kasım 2004 tarihleri arasında yaşları ortalama (ort) 51.5±33 olup, 3-487 (ort.135) ay önce trabekülektomi olan 1-3 (ort.1.75) gündür görme keskinliği (GK)’inde azalma, ağrı ve gözde kızarıklık şikayetleri ile başvuran 4 hasta klinik açıdan endoftalmi olarak değerlendirildi. Semptomların başlamasıyla kliniğimize başvuru arasındaki süre kısa olmasına rağmen GK’i 3 olguda ışık hissi (IH), 1 olguda ise el hareketleri (EH) düzeyindeydi. Tüm olgulara Pars Plana Vitrektomi (PPV) ve intravitreal antibiyotik enjeksiyonu uygulandı. Vitreustan alınan kültürlerde 2 olguda Streptococcus pneumoniae, 2 olguda ise Streptococcus pyogenes üredi. Olguların ort. 2 ay (1-4) ay takipleri sonrasında düzeltilmiş en iyi görme keskinliği (DEİGK) seviyeleri 1 olguda IH negatif, 1 olguda IH pozitif ve 2 olguda EH düzeyinde ve göz içi basınçları (GİB) ortalama 10±3.6 mmHg idi. Başvuru sırasında yapılan B-Scan USG’de vitreusta membran benzeri ekojenite artışı dışında retina dekolmanı tespit edilmemesine rağmen son muayenelerde 2 (%50) olguda total retina dekolmanı, 1 olguda ise optik atrofi saptandı. Sonuç: Trabekülektomi sonrası sıklıkla izole edilen Streptococcus species, görme keskinliği ve retinal hasar açısından son derece kötü prognozlu geç başlangıçlı endoftalmilere neden olmaktadır.

Keywords

Endoftalmit Streptococcus Trabekülektomi Vitrektomi Endophthalmitis Trabeculectomy Vitrectomy

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Cite This Article

ESER, İ., EREN, H., BAYRAKTAR, Ş., BAYRAKTAR, Z., KAPRAN, Z., YILMAZ, Ö. F. (2006). Four late-onset endophthalmitis due to Streptococcus species following trabeculectomy. Glokom Katarakt, Cilt: 1 - Sayı: 3, 221–223. https://ajindex.com/articles/226726

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