Research Article
Volume 11 Issue 1 - 2020
Risk Factors for Pars Plana Vitrectomy for Endogenous Endophthalmitis
Aditya Uppuluri1, Marco A Zarbin1,2 and Neelakshi Bhagat1,2*
1Rutgers New Jersey Medical School, Newark, NJ, USA
2Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
*Corresponding Author:Neelakshi Bhagat, Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA.
Received: November 20, 2019; Published: December 12, 2019


Purpose: The objective is to identify demographic, ocular, and microbial variables that are associated with an increased risk of undergoing pars plana vitrectomy (PPV) as part of management for endogenous endophthalmitis (EE). 

Methods: Using the 2002 - 2013 National Inpatient Survey Database, we performed a cross-sectional observational study of cases of EE. Variables with a p < 0.05 on univariate analysis were included in the multivariate regression model. An adjusted alpha-value of 0.00455 (0.05/11) was calculated using the Bonferroni Correction Method.

Results: A total of 2028 cases of EE were identified. Of these cases, 1821 (89.8%) cases occurred in the adult group (AG) (ages 22+) and 206 (10.2%) cases occurred in the pediatric group (PG) (ages 0 - 21). The average age in the AG was 61.9 years, and the average age in the PG was 2.8 years. Men comprised 54.2% of overall cases (61.2% in PG and 53.5% in AG). Of the 2028 cases of EE, 292 (14.4%) cases underwent vitrectomy: 282 (15.5%) were adult cases and 10 (4.9%) were pediatric cases. Through our univariate analysis, we found that age over 22, cataracts, chorioretinitis, retinal detachment, vitreous hemorrhage, panophthalmitis, orbital inflammation, anterior and posterior synechiae, methicillin-sensitive Staphylococcus aureus (MSSA) infection, and pseudomonal infection were associated with an increased risk of undergoing vitrectomy for EE; conversely, E. coli infection was associated with a decreased risk of undergoing vitrectomy. After multivariate analysis, with Bonferroni Correction to reduce the likelihood of type 1 error, age over 22, retinal detachment, orbital inflammation, synechiae, and MSSA infection remained significant risk factors of undergoing vitrectomy. 

Conclusion: In our analysis, only 10.2% of EE cases occurred in the pediatric group. The proportion of EE cases that underwent vitrectomy was higher in adults (15.5%) than in the pediatric (4.9%) group. Statistically significant variables associated with an increase in the likelihood of undergoing vitrectomy were age > 22 years, retinal detachment, orbital inflammation, anterior and posterior synechiae, and MSSA infection. We also noted that Streptococcal species, MSSA, methicillin resistant Staphylococcus aureus (MRSA), gram negative bacteria, and Candida were the most commonly cultured organisms from the blood of EE patients. 

Keywords: Endophthalmitis; Endogenous Endophthalmitis; Vitrectomy; Risk Factors; PPV; Pars Plana Vitrectomy


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Citation: Neelakshi Bhagat., et al. “Risk Factors for Pars Plana Vitrectomy for Endogenous Endophthalmitis”. EC Ophthalmology 11.1 (2020): 01-16

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