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The association between treatment method, microbiological findings, and visual acuity in endophthalmitis patients: A retrospective, multi-centred study

Eye volume 40, pages 406–411 (2026)Cite this article

Subjects

Abstract

Objective

Determine the association between initial treatment method (tap and inject [T/I] or pars plana vitrectomy [PPV]) and microbiology findings on post-treatment visual acuity (VA) in endophthalmitis patients.

Methods

This retrospective study evaluated patients treated for endophthalmitis in Toronto, Canada. The association between treatment, microbiology, and VA at 1-, 3-, 6-, and 12-months post-treatment was analysed using linear regression, adjusted for age, sex, time to treatment, and baseline VA.

Results

A total of 111 patients were treated with initial T/I (n = 93, 84%) or PPV (n = 18, 16%) between 2011 and 2023. Microbiology identified 69 (62%) culture-negative, 36 (32%) bacterial, and 6 (5%) fungal cases. Adjusted VA improvement did not differ between bacterial and culture-negative groups at all timepoints, including 1 month (–0.68 ± 0.86 vs. –0.69 ± 0.87 logMAR, p = 0.98, n = 102) and last measured follow-up (–1.01 ± 0.90 vs. –0.84 ± 0.83 logMAR, p = 0.35, n = 105). VA improvement also did not differ between T/I and PPV at all timepoints, including at 1 month (–0.66 ± 0.87 vs. –0.50 ± 0.78 logMAR, p = 0.55, n = 108) and last measured follow-up (–0.91 ± 0.86 vs. -0.60 ± 0.80 logMAR, p = 0.20, n = 111). Last measured follow-up time did not differ between T/I and PPV (6.0 vs. 3.8 months, p = 0.05) or between bacterial and culture-negative groups (6.1 vs. 5.6 months, p = 0.85). Retreatment rates were similar between T/I and PPV (35% vs. 33%, OR = 0.95, p = 0.93), but higher in bacterial vs. culture-negative cases (56% vs. 22%, OR = 4.80, p < 0.01).

Conclusions

Visual outcomes did not differ by treatment or microbiology. Bacterial cases had higher retreatment rates than culture-negative cases.

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Data availability

The dataset analysed during the current study is not publicly available due patient privacy but is available from the corresponding author in a deidentified format upon reasonable request.

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Acknowledgements

Dr. Rajeev H. Muni’s research is supported by the Silber TARGET Fund.

Author information

Authors and Affiliations

  1. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Shayaan Kaleem & Andrew Mihalache

  2. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

    Amir-Ali Golrokhian-Sani

  3. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada

    Abbie Lai

  4. Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Chris Zajner

  5. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Marko M. Popovic, Peter J. Kertes, Rajeev H. Muni & David T. Wong

  6. Faculty of Science, York University, Toronto, ON, Canada

    Sameen Kaleem

  7. John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Peter J. Kertes

  8. Department of Ophthalmology, St. Michael’s Hospital/Unity Health Toronto, Toronto, ON, Canada

    Rajeev H. Muni & David T. Wong

Authors
  1. Shayaan Kaleem
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Contributions

Shayaan Kaleem, AM, AG, AL, CJ, and Sameen Kaleem were responsible for designing the study, extracting the data, and analysing the data. MMP, PJK, RHM, and DTW were responsible for interpreting results and overseeing the project. All authors contributed to the writing and review of the manuscript and have approved the final version.

Corresponding author

Correspondence to David T. Wong.

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Competing interests

MMP: Financial support (to institution) – PSI Foundation, Fighting Blindness Canada. PJK: Honoraria: Novartis, Bayer, Roche, Boehringer Ingelheim, RegenxBio, Apellis; Advisory board – Novartis, Bayer, Roche, Apellis, Novelty Nobility, Viatris, Biogen, AdMare, Kriya Therapeutics; Financial support (to institution) – Roche, Novartis, Bayer, RegenxBio. DTW: Consultant – AbbVie, Alcon, Apellis, Bayer, Bausch Health, Biogen, Boehringer Ingelheim, Novartis, Ripple Therapeutics, Roche, Topcon, Zeiss. Research grants from Novartis, Roche. RHM: Consultant- Alcon,Apellis, AbbVie, Bayer, Bausch Health, Roche; Financial Support (to institution) - Alcon, AbbVie, Bayer, Novartis, Roche.

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Kaleem, S., Mihalache, A., Golrokhian-Sani, AA. et al. The association between treatment method, microbiological findings, and visual acuity in endophthalmitis patients: A retrospective, multi-centred study. Eye 40, 406–411 (2026). https://doi.org/10.1038/s41433-025-04125-1

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