Endophthalmitis in Oslo, Norway

Purpose: To study the incidence, aetiology, pathogenic causes, treatment and visual outcomes of endophthalmitis (EO) at the Department of Ophthalmology, Oslo University Hospital (OUS), Norway.

Methods: Retrospective registry study. Medical records of all EO patients treated at OUS over a 2-year period were reviewed.

Results: The study identified 46 EO eyes of 44 patients; 19 eyes had postcataract surgery EO (PCE), and 6 eyes had postinjection EO (PIE). Of 4778 primary cataract surgeries performed at OUS, there was one PCE (incidence 0.21 per 1000; 95% CI 0.04-1.19 per 1000). Of 38 134 intravitreal injections performed at OUS, there were 3 PIE (incidence 0.08 per 1000; 95% CI 0.03-0.23 per 1000). Among 15 751 cataract surgeries performed at other ophthalmic centres in Oslo and Akershus County (OOC), there were 15 PCE (incidence 0.95 per 1000; 95% CI 0.58-1.57 per 1000). Of 3000 intravitreal injections performed at OOC, there was one PIE (incidence 0.33 per 1000; 95% CI 0.059-1.89 per 1000). For neither PCE nor PIE, there were significant differences in odds ratios between OUS and OOC. The odds ratio for PCE versus PIE was, however, 8.0 (95% CI 2.7-24.0; p < 0.001). Cultures were positive in 35 of 46 eyes (76%). The most common pathogen was Staphylococcus epidermidis. Twenty-two eyes (48%) achieved a clinically significant improvement in visual function (≥0.3 logMAR) following treatment.

Conclusion: The overall risk of PCE and PIE was low. It was, however, higher for PCE than PIE, probably reflecting the relative difference in invasiveness between the procedures.