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2019
OMIG Abstract Purpose: To associate molecular detection of potential pathogens in endophthalmitis with clinical outcomes. Methods: Patients diagnosed with a post-surgical endophthalmitis following an intraocular procedure were recruited in a prospective, observational cohort study. Clinical data from baseline, week 1, month 1 and 3 visits were collected. Intraocular biopsy samples were cultured by standard methods. Quantitative polymerase chain reaction for specific pathogens and whole genome sequencing (WGS) were performed. Determinants of month 1 and 3 outcome were evaluated by Wilcoxon rank sum, Fisher’s test, and survival analyses. Results: A total of 50 patients (mean age 72, 52% male) were enrolled. Twenty-four cases were culture-positive and 26 were culture-negative. Torque teno virus (TTV) and merkel cell polyomavirus (MCV) were detected in 49% and 19% of cases, respectively. WGS identified the cultured organism in 76% of culture-positive cases and identified potential pathogens in 33% of culture-negative cases. Clinical outcomes of S. epidermidis endophthalmitis either by culture or molecular detection were no different than culture-negative cases and relatively favorable, while the cases infected with other pathogens trended towards worse outcome. Higher baseline bacterial loads of non-S.epidermidis infected cases were associated with worse month 1 and 3 visual acuity. Presence of TTV at presentation was associated with higher rate of secondary PPV (p=0.009), particularly for retinal detachment.
Conclusion: Molecular detection of specific potential pathogens, in particular non-S. Epidermidis and TTV are associated with a worse outcome in post-surgical endophthalmitis.
Disclosure: S: Supported by NIH/NEI K23EY024921 (CL), P30EY001730 (CL, RVG), Research to Prevent Blindness Unrestricted Grant (CL, AL, RVG), Mark J. Daily MD Research Fund (CL, AL, RVG).
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