First-line Surgical Versus Medical Treatment: A Retrospective Study From 2014 to 2024 in Brest (BRESTE)

First-line Surgical Versus Medical Treatment: A Retrospective Study From 2014 to 2024 in Brest

The goal of this observational cohort study is to evaluate the impact of early pars plana vitrectomy (PPV) on visual outcomes in adults diagnosed with acute endophthalmitis. It also aims to identify prognostic factors associated with visual recovery.

The main questions it aims to answer are:

Does early PPV (within 48 hours of diagnosis) improve visual acuity at 1 month compared with initial medical management? Which baseline clinical and microbiological factors are associated with worse visual outcomes?

Participants with acute endophthalmitis receiving standard care in routine clinical practice will be included. Patients undergoing early PPV will be compared with those receiving initial medical treatment alone or with delayed PPV to assess differences in visual outcomes.

Clinical data, including visual acuity, treatment characteristics, microbiological findings, and complications, will be collected retrospectively from medical records, with follow-up outcomes assessed at 1, 3, and 6 months.

Inclusion Criteria:

• Age ≥ 18 years
• Clinically diagnosed acute endophthalmitis
• Onset within 6 weeks following intraocular procedure (cataract surgery, intravitreal injection, anterior or posterior segment surgery)
• Endophthalmitis associated with trauma, infectious keratitis, bleb-related infection, or endogenous infection
• Availability of clinical data including visual acuity and treatment information

Exclusion Criteria:

• Age < 18 years
• Chronic endophthalmitis (> 6 weeks after procedure)
• Non-infectious conditions (e.g., toxic anterior segment syndrome, postoperative inflammatory reaction)
• Documented refusal or opposition to use of clinical data
• Insufficient clinical data, particularly missing visual acuity or treatment informationcuity or treatment information