Progression of diabetic retinopathy after endophthalmitis

Objective: To determine the effect of endophthalmitis on diabetic retinopat hy, Design: Noncomparative case series. Methods: The records of all consecutive patients with endophthalmitis treat ed between 1992 and 1997 at the Medical College of Wisconsin were retrospec tively reviewed. Those patients with diabetes mellitus were analyzed. Participants: From 77 reviewed records, 11 patients (12 eyes; 14%) were ide ntified as diabetics with endophthalmitis and were studied, Main Outcome Measures: Stage of diabetic retinopathy, time to retinopathy p rogression, and visual acuity, Results: Mean patient age was 68 years, and mean duration of diabetes was 1 1.7 years. Mean patient follow-up was 17 months. Of the six Gases without e vidence of retinopathy before the endophthalmitis, none went on to develop retinopathy, Of six eyes with pre-existing nonproliferative retinopathy, fo ur showed evidence of progression within 6 months of the infection. Three d eveloped severe proliferative disease and macular edema, and one developed severe nonproliferative disease. More patients without pre-existing retinop athy achieved a final Visual acuity of 20/40 or greater, Conclusions: Patients with pre-existing diabetic retinopathy may be at incr eased risk for vapid retinopathy progression and a poorer visual outcome af ter endophthalmitis, These results support the concept that inflammation ma y exacerbate diabetic retinopathy.