Kim, B. Michelle

Purpose: The purpose of this study is to characterize the clinical features, management strategies, and outcomes of endophthalmitis cases following pars plana vitrectomy using data from the American Academy of Ophthalmology (Academy) IRIS ® Registry (Intelligent Research in Sight). Methods: This is a retrospective cohort study of eyes that developed endophthalmitis following pars plana vitrectomy between 2013 and 2022. Data was collected from the Academy IRIS Registry. This study analyzed differences in visual acuity, intraocular pressure, rates of evisceration and enucleation, and rates of rhegmatogenous retinal detachment following endophthalmitis diagnosis. Results: A total of 1,223,777 unique eyes underwent a PPV during the study period, with 1,275 eyes meeting the inclusion criteria. The median time from pars plana vitrectomy to endophthalmitis diagnosis was 10 days. The majority of eyes (80.9%) were managed with intravitreal antibiotics alone, without a repeat pars plana vitrectomy. Long-term visual acuity, intraocular pressure, cup-to-disc ratio, and rate of evisceration or enucleation did not differ significantly between treatment groups. However, eyes that underwent the initial pars plana vitrectomy for retinal detachment repair had poorer long-term vision and higher rates of retinal detachment following endophthalmitis. Overall, 16.1% of eyes required evisceration or enucleation in this cohort. Conclusions: Despite its rarity, post-pars plana vitrectomy endophthalmitis can cause significant morbidity and even globe loss. There were no significant differences observed between eyes that were treated with intravitreal tap and inject versus repeat pars plana vitrectomy.

Purpose To describe the clinical characteristics, histopathologic subtype distribution, treatment, and outcomes of patients with primary orbital lymphoma. Major Findings There were 126 biopsy-confirmed cases of primary orbital lymphoma, with 81 (64.3%) female and 110 (87.3%) white. The average age at diagnosis was 62.7 ± 13.9 years. There were 26 (20.6%) cases with bilateral involvement. The most frequent lymphoma subtype was MALT lymphoma (N = 76, 60.3%), followed by diffuse large B-cell lymphoma (N = 18, 14.3%) and follicular lymphoma (N = 12, 9.5%). Prognosis was generally favorable, as local recurrence occurred in only 14 (11.1%) patients and final best corrected visual acuity (BCVA) loss of >1 line was seen in 30 (28.0%) patients. Bilateral lymphoma and advanced stage (Ann Arbor Stage III or IV) at presentation were associated with increased risk of local recurrence ( p = 0.0025, p = 0.049). Improved disease-specific survival was associated with diagnosis at Stage I or II ( p = 0.013), MALT subtype ( p = 0.034), or lack of chemotherapy requirement as primary treatment ( p = 0.0073). Conclusions In this single center academic cohort, MALT lymphoma subtype was most common. Overall orbital recurrence frequency was low, and bilateral lymphoma and advanced stage were associated with increased risk of local recurrence. MALT lymphoma subtype was associated with improved disease-specific survival. Long-term follow-up showed that most patients retained good visual acuity in the affected eye(s).