Andrew Hurley1,2, Penelope Allen1,3, Rosie Dawkins1,3, Will Atkins-Brown3,4
Purpose: Different precipitating events causing endophthalmitis introduce different microorganisms into the eye. We aim to establish the leading micro- bial causes in Victoria for each precipitating event and measure outcomes.
Method: Data was collected prospectively in the Victorian Endophthalmitis Registry from 1/1/2007 to 31/12/2017 at the Royal Victorian Eye and Ear Hospital (RVEEH), currently held as an online data- base created with REDCap. This captures all cases of endophthalmitis at the RVEEH with catchment throughout the state of Victoria. To ensure complete- ness, cross-checking against discharge diagnosis and data in-ﬁll was undertaken.
Results: In the 10 year time period 522 endophthal- mitis cases were recorded. Cataract surgery associ- ated endophthalmitis (n = 159) resulted in mostly gram-positive organisms (51.0%), particularly coag- ulase negative staphylococcus species (27.1%). Intravitreal injection associated endophthalmitis (n = 117) resulted in some coagulase negative staph- ylococcus (29.9%), but also more streptococcal infec- tions (17.1%) as compared to cataract surgery (11.9%). Glaucoma drainage surgery (n = 58) intro- duced a range of organisms, notably gram-negative organisms (17.2%). Endogenous endophthalmitis (n = 76) was commonly caused by fungal infection (26.3%), particularly Candida albicans, though some unusual organisms were cultured. Corneal ulcera- tion (n = 56) was the precipitating event with the worst outcomes with 32% of patients receiving enucleation.
Conclusion: Clinicians should be aware of likely microorganisms according to precipitating factor, so they can prescribe the appropriate empirical intravi- treal antibiotics, and arrange early vitrectomy for more aggressive disease. This data conﬁrms that the empirical endophthalmitis protocol at the RVEEH remains appropriate for the Victorian clinical pattern of microbiology.
COMPARISON OF RANIBIZUMAB AND AFLIBERCEPT IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATED FOLLOWING A ?TREAT AND EXTEND? PROTOCOL: EFFICACY VARIABLES FROM THE PRE-SPECIFIED 12- MONTH INTERIM ANALYSIS OF THE RIVAL STUDY