REVIEWS   

Minerva Oftalmologica 2009 September;51(3):93-111

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Endophthalmitis: clinical settings, laboratory researches and therapy

Nuzzi R. ¹, Tonini L. ¹, Consolandi G. ², Pollino C. ³, Giardini F. ³

¹ Dipartimento di Fisiopatologia clinica, Ospedale Oftalmico di Torino, Università degli Studi di Torino, Italia 2 Università del Piemonte Orientale “Amedeo Avogadro”, Facoltà di Medicina e Chirurgia, Novara, Italia 3 Laboratorio analisiOspedale Oftalmico di Torino, Torino, Italia

Currently, endophthalmithis represent, for their severity, an important clinical problem: in the majority of cases, in fact, visual outcome is really poor. Clinical evidences shows that a prompt diagnosis and antibiotic therapy are fundamental to avoid the loss of the eye itself, but often is not enough. The most commonly kind of endophthalmithis are the exogenous one: posttraumatic and postoperative, that can complicate any intraocular surgery. They result from infection with eyelid margin and tear film or carried by intraocular foreing bodies microrganisms. The clinical settings are different and show various symptoms: the inflammation can be limited to the anterior camera without pain or can dramatically involved not only the eye but also the periocular tissues. Therapy firstly avail of combined broad-spectrum antibiotics, chosen also considering the possible resistance: to obtain a clinical efficacy, an intravitreal injection should be immediate and, if necessary, with topic and systemic therapy as adjunct treatment. The host inflammatory response is always present during endophthalmitis develop and corticosteroids administration is used to protect retina from permanent damage. The most severe cases can receive also pars plana vitrectomy (20,23 or 25 G). After more then ten years from results publication of the EVS (Endophthalmithis Vitrectomy Study), the larger endophthalmithis study, it’s been revaluated the role of this therapeutic approaches but many question are still controversial.