Objective: To identify pathogenic organisms and prognostic factors associated with the visual outcome in endogenous endophthalmitis patients.

Materials and Methods: A retrospective review of medical record from 65 patients diagnosed with endogenous endophthalmitis at Department of Ophthalmology, Siriraj Hospital, Thailand between January 2003 and December 2014 was done.

Results: There were 68 eyes from 65 patients diagnosed with endogenous endophthalmitis. Seventy-six percent of patients had initial visual acuity [VA] ranging between hand motion [HM] and light perception. Diabetes mellitus [DM] was the most common underlying disease. The pathogenic organisms could be identified in 48 cases (70.6%). The identified pathogenic organisms were gram-positive bacteria 39.7%, gram-negative bacteria 23.5%, fungus 1.5%, and mixed organisms 5.9%. Most of the pathogenic organisms were Streptococcus spp. (23.5%) and Klebsiella pneumoniae (13.2%). Patients who were treated with vitrectomy have 30% lower rate of enucleation compared to patients who were not treated with vitrectomy (p = 0.007). Among the prognostic factors, good initial VA (better than HM) was significantly related to a successful VA outcome (VA better than HM, p-value <0.001). Nevertheless, approximately 70% of the patients had VA outcome worse than counting finger.

Conclusion: The trend of pathogenic organisms may be changing from the past, as the authors found the increasing ratio of grampositive bacteria over 12 years. Although the patients were treated with sufficient anti-infective agents, most of the visual outcome was poor. Good initial VA was a significant prognostic factor for the visual outcome and vitrectomy could reduce rate of enucleation.

Keywords: Endogenous endophthalmitis, Pathogenic organisms, Risk factors, Treatment, Vitrectomy, Enucleation