Retinal Detachment After Endophthalmitis: Risk Factors and Outcomes

Tiantian Wang,1,2 Omar Moinuddin,1 Rebhi Abuzaitoun,1 Min Hwang,1 Cagri Besirli,1 Thomas J Wubben,1 David N Zacks1 1Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA; 2Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of ChinaCorrespondence: David N ZacksUniversity of Michigan, Kellogg Eye Center, 1000 Wall St., Ann Arbor, MI, 48105 Tel +1 734-936-0871Email davzacks@umich.eduPurpose: To analyze the risk factors, clinical course, and visual and anatomic outcomes of retinal detachment (RD) after endophthalmitis.Patients and Methods: This retrospective study included 108 patients diagnosed with endophthalmitis between August 2014 and May 2019 at a single tertiary referral center. Sixteen patients developed RD after endophthalmitis. Retrospective analysis was performed to compare the cohort of endophthalmitis alone versus the cohort that developed RD after endophthalmitis, with analysis of potential risk factors for RD after endophthalmitis and treatment outcomes.Results: The incidence of RD after endophthalmitis was 14.8% (N=16/108). The median time to develop RD after endophthalmitis was 27 days (range: 1– 581 days, IQR: 25.3). Thirteen (81.3%) cases of RD occurred less than 2 months after the diagnosis of endophthalmitis. The incidence of aphakia (p=0.023) and posterior synechia (PS) (p=0.014) were significantly higher in the RD group. The mean initial and final visual acuity (VA) of the endophthalmitis alone group was 1.9± 0.8 logMAR and 1.2± 1.0 logMAR (p< 0.0001), respectively, and 1.9± 0.9 logMAR and 1.3± 1.2 logMAR (p=0.07) in the RD group, respectively. Enucleation or evisceration occurred in 31.3% of cases with RD after endophthalmitis. The rate of final retinal re-apposition for the RD cohort was 56.3%.Conclusion: The anatomic and functional outcomes for RD after endophthalmitis remain poor, with significant risk for permanent vision loss. Aphakia and posterior synechiae were seen more often in cases with RD after endophthalmitis.Keywords: pars plana vitrectomy, intraocular inflammation, aphakia, posterior synechiae, vision loss