Summary:
The aim of this study was to evaluate the ultrasound findings in eyes with
endophthalmitis following penetrating injury and to establish unfavorable
predictive signs of this serious disease. In a retrospective study we evaluated
findings in 7 eyes of 7 patients followed up because of posttraumatic endophthalmitis at the Department of Ophthalmology, School of Medicine, in
Olomouc, Czech Republic, EU, during the period September 1999 – December
2004. The mean age of the patients was 37.3 years (range 22-49 years). The mean
duration of the period between the injury and the formation of the
endophthalmitis was 8.4 days (range 1 – 21 days). The visual acuity at the time
of admittance was very low; it ranged between light perception and 1/60 (0,016
or 20/1200). All patients underwent diagnostic-therapeutic pars plana
vitrectomy with vitreous samples taken for microbiological examination and
intravitreal antibiotic application. The final visual acuity (VA) ranged from
1/60 (0,016 or 20/1200) to 6/12 (0.5 or 20/40), so it was very variable and that gave
us the possibility to follow the connection between the final VA and seriousness
of the penetrating injury, and also with the interval between the emergence of
the endophthalmitis and beginning of its treatment. During the ultrasound
examination, the presence of membranes in the vitreous body, posterior
vitreous detachment, thickening of the choroid, detachment of the choroid and
detachment of the retina were of concern to us. Membranes were present in the
vitreous in 5 eyes. Without membranes detected by the ultrasound, there were
2 eyes; in both of them the final VA was better than 6/36 (0,1667 or 20/120). The
posterior vitreous detachment was detected in 3 eyes, and not detected in four
eyes.We didn’t find any connection between the final VA and posterior vitreous
detachment. The thickening of the choroid was present at the ultrasound
examination in all seven eyes. The detachment of the choroid was not found in
any eye. The retina was detached in two eyes. In three eyes only, the final
central VA was better than 6/36 (0.1667 or 20/120). In two of them, the
intraocular foreign body was found and in both the bacteria Staphylococcus
epidermidis was detected. In the third eye, the soil bacteria Enterococcus and
Klebsiela were cultivated. The ultrasound findings in these three eyes are
identical only in the term of thickening of the choroid, similar to other eyes. In
two of them no membranes were detected by ultrasound and no posterior
vitreous detachment was found. The ultrasound examination in eyes with
endophthalmitis after penetrating injury is specific in particular because of
the mechanism of the injury. In contrast to the cases of the postoperative
endophthalmitis, no prognostic unfavorable sings in the ultrasound
examination can be strictly identified.
Key words:
ultrasound, endophthalmitis
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