Retinal Status on OCT After Endophthalmitis Following Cataract Surgery
By Marianne Doran and selected by Deepak P. Edward, MD
British Journal of Ophthalmology
Published online Jan. 24, 2017
Zhou et al. analyzed optical coherence tomography (OCT) images to assess macular parameters in patients who developed acute postcataract endophthalmitis. They found that epiretinal membrane (ERM) and macular edema (ME) were the main macular abnormalities 12 months after the acute endophthalmitis.
This multicenter longitudinal observational study included 46 patients who had clinical signs of endophthalmitis within 6 weeks after cataract surgery. Acute management was at the discretion of the treating physician, most often with intravitreal antibiotic injection, sometimes with the addition of topical antibiotics and dexamethasone or pars plana vitrectomy in severe cases. OCT imaging of the macula was performed at 3, 6, and 12 months to assess central macular thickness (CMT); perifoveal macular thickness; central foveal point thickness; and abnormalities of the outer retina, macula, and vitreoretinal interface.
During follow-up, macular abnormalities were observed on OCT in 55%-63% of the patients; at month 12, the macula appeared normal in 45% of patients. In months 3-12, the researchers noted that ERM prevalence increased from 26% to 39%, vitreomacular traction prevalence decreased from 12% to 6%, and nontractional ME prevalence varied between 7% and 13%. Macular thinning remained stable at 10%. At month 12, a significant correlation was found between nontractional ME and capsular rupture during cataract extraction. Eyes with an ERM had increased CMT and lower visual acuity (VA) at month 12 compared with the group with a normal macular appearance. The researchers also found a significant association between ERM and alteration of the ellipsoid band as well as the external limiting membrane.
The researchers noted that their study was the first to report the prevalence of macular complications, as seen on OCT, after treatment of acute postcataract endophthalmitis and the progression over 12 months. They concluded that ERM and ME are the main macular abnormalities diagnosed in the first year of follow-up. Nevertheless, despite these 2 complications, 50% of the cases attained a VA of 20/40 or better.
The original article can be found here.