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  • Retinal Status on OCT After Endophthalmitis Following Cataract Surgery

    By Marianne Doran and selected by Deepak P. Edward, MD

    Journal Highlights

    British Journal of Ophthalmology
    Published online Jan. 24, 2017

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    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.