Endophthalmitis

Endophthalmitis: a bibliometric study and visualization analysis from 1993 to 2023

Aims

This study is designed to generalize and depict the research hotspots of endophthalmitis through bibliometric methods and software and analyze the evolutive tendency of the work on this severe disease over the past 30 years.

Methods

This study employed a rigorous bibliometric approach. We identified all endophthalmitis-related literature by conducting a comprehensive search of the Science Citation Index Expanded database under the Web of Science Core Collection. The data was then analyzed and visualized using CiteSpace and VOSviewer, two widely recognized software tools in the field of bibliometrics. CiteSpace was used to analyze the country distributions, dual map overlay of journals, keyword bursts, and co-cited references. VOSviewer was employed to describe the authors and co-cited authors, the journals, the co-cited journals, and the keywords co-occurrence network. This robust methodology ensures the reliability and validity of the study's findings.

Results

A total of 2960 publications, including 2695 articles and 265 reviews, were included in this bibliometric study. There has been no shortage of endophthalmitis-related publications since 1993, with an apparent upward trend during recent years. Possible correlations with the COVID-19 pandemic are also analyzed. These studies were finished by 11,048 authors from 75 countries worldwide, with the United States in the lead. In the keyword co-occurrence network, except for the endophthalmitis term, cataract surgery becomes the keyword with the highest frequency. Different categories of endophthalmitis, including postoperative, post-injection, post-traumatic, and endogenous endophthalmitis, and antibacterial and anti-inflammatory therapies of infectious endophthalmitis, are discussed by categories. From the perspective of the timeline, postoperative and post-injection endophthalmitis were the dominant forms before and after the year 2000, respectively. Co-citation analyses reveal that the Endophthalmitis Vitrectomy Study (EVS) conducted in 1995 provides pivotal guidance for later research. Diverse pathogenic bacteria (e.g., Coagulase-negative Staphylococci, Propionibacterium acnes, Viridians Streptococci, and Bacillus cereus) or fungi (e.g., Candida, Aspergillus, and Fusarium) contribute to varying treatment principles and clinical prognosis, which should be taken seriously. In addition, intravitreal and intracameral antibiotics are the mainstay for treating and preventing infectious endophthalmitis, respectively.

Conclusion

Our bibliometric analysis provides an overview of dynamic evolution and structural relationships in the research field of endophthalmitis. The displayed hotspots and developmental directions have reference values for future investigation.

Endogenous Endophthalmitis in the American and Korean Population: An 8-year Retrospective Study

PURPOSE

To study the clinical features of endogenous endophthalmitis (EE) in sample patient populations from the USA and South Korea over an 8-year period.

METHODS

We reviewed data from 128 eyes of 60 American and 48 Korean patients diagnosed with EE and compared their clinical characteristics.

RESULTS

Fungemia and liver abscess were the most common extraocular infection sources among American (26.7%) and Korean patients (33.3%), respectively. Klebsiella pneumoniae and Candida species were the most common pathogens of EE in the Korean and the American patients, respectively. Endophthalmitis caused by fungi had a better visual prognosis than that caused by bacteria (p = 0.001). Vitrectomy was beneficial for eyes with EE due to virulent bacteria presenting with worse than counting finger vision.

CONCLUSIONS

The predisposing conditions and responsible organisms for EE vary in different regions of the world. The visual prognosis was strongly influenced by the underlying pathogen.

The microbiology of endophthalmitis: global trends and a local perspective

Endophthalmitis is a rare but frequently devastating infection, caused by diverse organisms, including bacteria, viruses, fungi, and parasites. The causative agents of endophthalmitis vary according to the mechanism. The involvement of intraocular structures can result from exogenous spread from ocular trauma, infection of adjacent structures, or as a complication of intraocular surgery. Of the causes of exogenous endophthalmitis, post-operative endophthalmitis is the most frequently encountered; specifically, cataract surgery is the most frequent eye surgery and, thus, leads the list of surgery-associated endophthalmitis. Exogenous source is far more common than endogenous endophthalmitis, a disease that is caused by the hematogenous spread of organisms from a remote infectious site to the eye, leading to severe visual loss. Several large series estimate that endogenous endophthalmitis accounts for 2-15 % of all cases of endophthalmitis. Progressive vitritis is a hallmark for all forms of endophthalmitis, accompanied by intraocular inflammation, loss of vision, pain, and hypopyon. The common presentation consists of reduced vision, conjunctival injection, pain, and eyelid swelling. We reviewed the microbiology of endophthalmitis during a 9-year period in Winnipeg, Canada. Gram-positive bacteria with coagulase-negative staphylococci are the most common causative organisms, reflecting the association with surgical procedures.

Fungal, Mycobacterial, and Nocardia infections and the eye: an update

Although relatively uncommon, fungi, atypical Mycobacteria, and Nocardia have been isolated from a variety of infections of eye including keratitis, scleritis, canaliculitis, dacryocystitis, endophthalmitis and orbital cellulites. The organisms typically cause a slowly progressive disease. The diseases caused by the organisms can pose both diagnostic and therapeutic challenges. In this manuscript we will describe updates on important aspects of the ocular infections caused by these organisms.

Shifting trends in in vitro antibiotic susceptibilities for common ocular isolates during a period of 15 years

PURPOSE

To assess the in vitro susceptibility of the most common ocular bacterial isolates to several antibiotics and verify changing trends in the antibiotic susceptibility in a 15-year period.

DESIGN

Experimental study.

METHODS

All cultures positive for Staphylococcus aureus, coagulase-negative Staphylococcus (CNS), Streptococcus sp, and Pseudomonas sp in conjunctival (n = 4,585) and corneal (n = 3,779) samples from patients seen at the Federal University of São Paulo from 1985 to 2000 were evaluated. Cultures were performed in liquid and solid media, and susceptibility tests were done to amikacin, gentamicin, neomycin, tobramycin, ciprofloxacin, norfloxacin, ofloxacin, cephalothin, and chloramphenicol.

RESULTS

Amikacin and neomycin showed an improvement of their sensitivity during the study period (88%-95% and 50%-85%, respectively) for corneal and conjunctival samples. Gentamicin and tobramycin revealed a decrease of sensitivity in time, from 95% to less than 80% in corneal and conjunctival samples. Ciprofloxacin, norfloxacin, and ofloxacin had good sensitivity to all evaluated bacteria, better in conjunctiva (95%) than in cornea (90%). Sensitivity of S. aureus to cephalothin decreased during the study but was still 98% for CNS. Chloramphenicol had good sensitivity to S. aureus (85% in corneal and 92%in conjunctival samples), CNS (87% and 88.5%), and Streptococcus sp (95% and 96%).

CONCLUSIONS

Gentamicin, tobramycin, and cephalothin decreased their in vitro susceptibility to all tested pathogens. The fluoroquinolones remained a good choice in the treatment of ocular infections, with high suscep-tibility to all pathogens tested. Chloramphenicol also revealed an increase in its susceptibility to all bacteria evaluated.

Experience with coding accuracy for endophthalmitis

The Endophthalmitis Population Study of Western Australia aims to investigate the epidemiology of endophthalmitis, a potentially sight-threatening infection of the internal eye, in Western Australia in 1980-1998. Cases of endophthalmitis were identified from coded hospital discharge data, surgeon logbooks, and hospital microbiology and anaesthetic databases. This process uncovered not only widespread miscoding for endophthalmitis, but also systematic misuse of the endophthalmitis codes for external eye infections. The level of miscoding and code misuse has improved since the mid-1990s, and probably reflects the introduction of coding standards and trained coders into the Western Australian health system.