ECHOGRAPHIC FINDINGS IN INFECTIOUS ENDOPHTHALMITIS

Objective: To correlate the initial echographic findings in eyes with infectious endophthalmitis with the visual prognosis and causative mic roorganism. Design: A retrospective review of the clinical and standar dized ocular echographic findings in eyes with infectious endophthalmi tis was performed. Setting: University-based ophthalmology department. Study Participants: One hundred thirty-seven eyes (136 patients) with infectious endophthalmitis that were evaluated by the ocular echograp hy service of the Doheny Eye Institute, Los Angeles, Calif, between Ja nuary 1, 1981, and December 31, 1992. Results: Four findings on initia l echography were associated with poor initial vision: dense vitreous opacities, retinal detachment, macular detachment, and choroidal detac hment. Five findings on initial echography correlated with poor final vision: dense vitreous opacities, vitreous membranes, the presence of retinal detachment, the extent of retinal detachment, and the presence of choroidal detachment. Change (decrease) in vision during the follo w-up period was associated with the presence of combined vitreous and subhyaloid opacities, retinal detachment, and choroidal detachment. Al l eyes with initially clear vitreous on ocular echography had either e arly streptococcal or culture-negative endophthalmitis. Advanced strep tococcal endophthalmitis correlated with the most severe vitreous infl ammation, vitreous membranes, and the most extensive posterior vitreou s detachment, whereas gram-negative endophthalmitis correlated with ch oroidal detachment on initial echography. Stepwise logistic regression analysis revealed that the presence of choroidal detachment, not gram negative microorganisms, was the principal predictor of poor visual ou tcome in these eyes. Conclusion: Ocular echography is a useful method in the clinical evaluation and treatment of infectious endophthalmitis , especially in eyes with opaque media.