Table 4 Summary of initial and final visual acuity, treatment interventions and final outcomes of SRA with systemic foci
From: Subretinal abscess: causative pathogens, clinical features and management
S/N | Study | Pathogen | Initial VA (logMAR) | Final VA (logMAR) | Treatment | Outcome |
|---|---|---|---|---|---|---|
1 | Manor, Ophthalmologica | not isolated | 1.0 | 0 | - systemic antibiotics (not specified) - retrobulbar depomedrol | better VA |
2 | Davidson, Trans Am Ac Ophthalmol | Nocardia Asteroides | N/A | – | - systemic steroids - topical steroids - enucleation | enucleated |
3 | Fleming, Can J Ophthalmol | Candida Albicans | N/A | – | systemic antibiotics (not specified) | N/A |
4 | Naidoff, Am J Ophthalmol | Aspergillus Fumigatus | 2.7 | – | - intravenous amphotericin - intravitreal amphotericin - topical steroid - enucleation | enucleated |
5 | Hiss, Ophthalmology | Criptococcus Neoformans | 0.5 | 2.7 | - intravitreal amphotericin - intravenous amphotericin - oral 5-fluorocytosine - scleral buckling | worse VA |
6 | Mamalis, Ann Ophthalmol | Nocardia Asteroides | 1.4 | 2.3 | intravenous salfadiazine and sulfisoxazole | worse VA |
7 | Gregor, Retina | Nocardia Asteroides | 1.9 | 0.3 | - intravenous amphotericin - oral 5 fluorocytosine - intravenous thrimetoprim-sulfametoxazole | better VA |
8 | Coll, Retina | S. aureus | 1.9 | 1.3 | intravenous antibiotics for endocarditis (oxacillin and gentamicin) | better VA |
9 | Webber, British J Ophthalmol | Pseudomonas A. | 2.3 | 2.3 | - systemic amphotericin and ganciclovir - 1st vitrectomy - SRA drainage + intravitreal amikacin, vancomycin and amphotericin B - intravitreal colomycin - intravenous imipenem - 2nd vitrectomy + lensectomy + silicone oil + encircling | same VA |
10 | Biswas, Retina | Mycobacterium TB | 0.5 | – | - oral prednisolone - topical steroids - periocular hydrocortisone - 1st vitrectomy + lensectomy - intravitreal cefazolin, gentamicin and dexamethasone - 2nd vitrectomy - ATT - evisceration - ATT - topical steroid + atropine | eviscerated |
Mycobacterium TB | 2.3 | 0.6 | better VA | |||
11 | Jolly, Arch Ophthalmol | Nocardia Asteroides | N/A | N/A | intravenous trimethoprim-sulfamethoxazole and amikacin | N/A |
12 | Yarng, Ophthal Surg Las Im | Klebsiella P. | 2.3 | 1.6 | - intravenous cefonicid, gentamicin, amikacin and cefazolin - intravitreal cefazolin and amikacin × 6 - 6 x intravitreal dexamethasone - vitrectomy + silicone oil + lensectomy + SRA drainage + buckle | better VA |
13 | Rimpel, British J Ophthalmol | Streptococcus Viridans | 2.7 | – | - intravenous vancomycin and ceftazidime - 3 x intravitreal vancomycin - evisceratio | eviscerated |
14 | Lakosha, Retina | Nocardia Farcinica | 0 | 2.3 | trimethoprim-sulfametoxazole | worse VA |
15 | Harris, Am J Ophthalmol | Klebsiella P. | 0.2 | 0.2 | - ampicillin, gentamicin, and metronidazole, then piperacillin-tazobactam, gentamicin, then ceftriaxone, gentamicin, and metronidazole - intravitreal amikacin and vancomycin - vitrectomy + SRA removal + amikacin + lensectomy - topical prednisolone and ciprofloxacin - oral prednisone - 2nd vitrectomy + endolaser | same VA |
16 | Costen, Eye | Streptococcus Pyogenes | 0.3; 0.5 | 0.2; 0.2 | - intravenous ceftriazone, amoxicillin, benzylpenicillin, cephradine - oral chloramphenicol, clindamycin, ciprofloxacin | BE better VA |
17 | Yao, Eur J Pediatr | Klebsiella P. | N/A | 1.9 | - AC irrigation + vitrectomy + intravitreal vancomicyn and amikacin + intravitreal dexamethasone - intravenous ceftriaxone - 2nd vitrectomy + SRA drainage - 3rd vitrectomy + buckle + silicone oil | N/A |
18 | Yoon, Retina | Klebsiella P. | 2.3 | 1.9 | - intravitreal amikacin and ceftazidime - 1st vitrectomy + SRA drainage - 2nd vitrectomy +silicone oil | better VA |
Klebsiella P. | 0.4; 0.7 | 1.5; 1.4 | - BE intravitreal vancomycin and amikacin - vitrectomy + SRA drainage | BE worse VA | ||
19 | Bozbeyoglu, Retina | Nocardia Asteroides | 0.3 | 2.3 | - intravenous amphotericin, cefotaxime, amikacin, trimethoprim–sulfamethoxazole - intravitreal amphotericin | worse VA |
20 | Shah, Indian J Ophthalmol | Candida A. | 1.9; 1.9 | 0.8; 0.8 | - BE intravitreal amphotericin - oral itraconazole - topical natamycin | BE better VA |
21 | Wjjesekera, Eye | Pseudomonas A. | 0 | – | - dexamethasone drops - isoniazid and pyridoxine - intravitreal amikacin and vancomycin - vitrectomy + intravitreal amikacin and vancomycin - oral steroids and oral ciprofloxacin - evisceratio | eviscerated |
22 | Motley, Retina | Pseudomonas A. | 0.5 | – | - topical prednisolone and ketorolac - vitrectomy + intravitreal vancomycin, ceftazidime, and amphotericin - intravenous ceftazidime and tobramycin - 2 x intravitreal and subconjunctival ceftazidime, tobramycin and vancomycin - 2nd vitrectomy + trans-scleral drainage + silicon oil - 3rd vitrectomy + SRA endoresection + silicone oil - enucleation | enucleated |
23 | Yu, Am J Neurorad | Nocardia Asteroides | 2.3 | – | - antiviral therapy (not specified) - vitrectomy - enucleation | enucleated |
24 | Rafiei, Europ J Ophthalmol | Nocardia Asteroides | 1.9 | 2.3 | - systemic cotrimoxazole, linezolid, ciprofloxacin - topical cycloplegic and steroids | worse VA |
25 | Dodds, Ocul Imm Inflamm | Nocardia Farcinica | 1.9 | – | - intravenous ceftriaxone, clyndamicin, and fluconazole. Then intravenous trimethoprim -sulfamethoxazole - intravitreal amikacin - vitrectomy + SRA aspiration - oral ciprofloxacin | N/A |
26 | Yang, Ophthalmol | Klebsiella P. | N/A | 1.0 | - intravenous cephalosporin and aminoglycoside - intravitreal antibiotics | N/A |
27 | Contreras, Ret Cas Brief Rep | Candida A. | 0.4; 1.9 | 0.1; 0.7 | intravenous caspofungin | BE better VA |
28 | Christoforidis, Ret Cas Brief Rep | Klebsiella P. | 2.3 | 0.4 | - intravitreal vancomycin, ceftazidime and dexamethasone - oral prednisone - topical atropine, prednisolone - vitrectomy + intravitreal vancomycin and ceftazidime - intravitreal ceftriaxone - 2nd vitrectomy + SRA drainage + intravitreal ceftazidime - 3rd vitrectomy + scleral buckle | better VA |
29 | Li, Int Ophthalmol | Pseudomonas A. | 2.3 | – | - intravenous ticarcillin and clavulanate, gentamicin - topical levofloxacin - enucleation | enucleated |
30 | Jones, Eye | Nocardia Asteroides | 2.3 | 1.6 | - intravitreal amikacin and vancomycin - systemic cotrimoxazole, linezolid and ciprofloxacin | better VA |
31 | Trigui, Int Ophthalmol | S. aureus | 0.7 | 0 | - intravenous ceftriaxone | better VA |
32 | Eschle-Meniconi, Surv Ophthalmol | Nocardia Asteroides | 2.3 | 0.1 | - intravenous ceftriaxone, clarithromycin and trimethoprim-sulfamethaxozole - vitrectomy + retinectomy + SRA aspiration + silicone oil | better VA |
33 | Gupta, Ret Cas Brief Rep | Pseudomonas A. | 2.3 | 1.9 | - topical ciprofloxacin and gentamicin, then topical ceftazidime and tobramycin - oral cephalexin - intravenous piperacillin–tazobactam, vancomycin and tobramycin | better VA |
34 | Peeler, J Neuro-ophthalmol | S. aureus | 2.3; 0 | 1; 0 | - intravenous rifampin, nafcillin, and gentamicin - intravitreal vancomycin × 2 and ceftazidime | RE: better; LE: same |
Bacillus | 1.9 | 2.3 | - intravenous vancomycin, cefepime, metronidazole, voriconazole, levofloxacin - intravitreal vancomycin × 2 and ceftazidime × 2 - topical moxifloxacin, prednisolone, atropin | worse VA | ||
35 | Eisenberg, Ret Cas Brief Rep | Nocardia Asteroides | 0.7 | 0.3 | - intravitreal vancomycin and × 2 amikacin- - systemic vancomycin, sulfamethoxazole/trimethoprim and meropenem | better VA |
36 | Arai, Clin Ophthalmol | Candida A. | 0; 1.4 | 1.7; − | - intravenous acetylspiramycin + valganciclovir - LE vitrectomy - imipenem/cilastatin, amikacin and levofloxacin - LE intravitreal ceftazidime, vancomycin and voriconazole - LE exenteratio - systemic fosofluconazole - RE 3 x intravitreal ceftazidime, vancomycin and voriconazole - RE vitrectomy + phaco + silicone oil | RE: worse VA; LE eviscerated |
37 | Siu, BMJ Cas Rep | Klebsiella P. | 0 | 1 | - intravenous piperacillin/tazobactam, amoxicillin/clavulanate, ceftriazone - oral ciprofloxacin - intravitreal amikacin and ceftazidime - 1stvitrectomy + SRA + silicone oil + intravitreal vancomycin and ceftazidime - encircling band + 2nd vitrectomy + silicone oil + phaco | worse VA |
38 | Shetty, Indian J Ophthalmol | Mycobacterium TB | 0.2 | 0.9 | - IV methyl prednisolone, then oral prednisolone - ATT + oral steroids | worse VA |
39 | Silva, Retina | Nocardia Cyriacigeorgica | 0 | 0.1 | - vitrectomy + retinotomy + SRA biopsy - systemic TMP-SMX and intravenous ertapenem - × 4 intravitreal amikacin | worse VA |
Nocardia Farcinica | 1.4 | 2.3 | - 1st vitrectomy + lensectomy + SRA biopsy + intravitreal Vancomycin, amikacin, amphotericin - systemic thrimetoprim.-sulfamethoxazole + oral ciprofloxacin and amikacin - 2nd vitrectomy + silicone oil | worse VA | ||
Nocardia Farcinica | 0.7 | – | - pyrimethamine, sulfonamide, and folinic acid - vitrectomy + SRA biopsy - intravenous TMP-SMX, ceftriaxone and amikacin - × 3 intravitreal amikacin - enucleation | enucleated | ||
40 | Won Jin, Optom Vis Sci | Klebsiella P. | 0.7; 1.2 | 0; 3 | - intravenous acyclovir, ceftazidime + oral prednisolone - LE vitrectomy + intravitreal vancomycin and ceftazidime - intravenous Ceftazidime - RE intravitreal vancomycin and ceftazidime - oral levofloxacin - intravitreal ceftazidime × 3 RE and ×1 LE | RE: better VA; LE: worse VA |
41 | Richards, Clin Exp Ophthalmol | Nocardia Beijingensis | 0.2; 2.3 | 0.3; 2.3 | - oral prednisolone - LE vitrectomy + silicone oil + subretinal biopsy - systemic meropenem, ceftriaxone, trimethoprim-sulphamethoxazole and amikacin - RE 3 x intravitreal amikacin | RE worse VA; LE same VE |
42 | Tsai, BMC Ophthalmol | not isolated | N/A | 0 | - vitrectomy + intravitreal ceftazidime and amikacin - intravenous ceftriaxone | N/A |
43 | Kamath, BMK | Mycobacterium TB | 1.8 | N/A | - ATT (rifampicin, pyrazinamide, isoniazid and ethambutol) - oral steroids | N/A |
44 | Schlaenm Ret Cas Brief Rep | Fusarium Solani | 1.9 | N/A | - systemic piperaciline, tazobactam, imipenem, voriconazole - vitrectomy + SRA drainage + intravitreal amphotericin and voriconazole - intravenous amphotericin | N/A |
45 | Venkatesh, Int J Ret Vitr | not isolated | 1.9 | 0.6 | - intravenous vancomycin and ceftriaxone - intravitreal vancomycin and ceftazidime - vitrectomy + SRA intralesional vancomicin | better VA |
46 | Soria, Cas Rep Ophthalmol | Mycobacterium TB | 1.9 | 1.9 | ATT (isoniazid, rifampin, pyrazinamide, and ethambutol) | same VA |
47 | Martel, J Fran Ophtalmol | Klebsiella P. | 0.2 | 0 | - IV ceftriaxone and amikacin, then levofloxacin - intravitreal 13 x ceftazidime and 7 x vancomicin - dexamethasone drops | better VA |
48 | Ganesh, Indian J Ophthalmol | Mycobacterium TB | 1.0; 0.3 | 1.5; 0.2 | - ATT (isoniazid, rifampicin, pyrazinamide) + oral steroids - azathioprine + intravenous steroids - vitrectomy | RE worse VA; LE better VA |
49 | Kimura, Cas Rep Ophthal | Klebsiella P. | N/A | 3.0; 1.7 | - BE intravitreal ceftazidime - intravenous linezolid - LE vitrectomy + silicone oil | N/A |
50 | Boonsopon, J Med Cas Rep | Mycobacterium TB | 3.0 | – | - isoniazid, rifampicin, pyrazinamide and ethambutol - intravenous amikacin, levofloxacin, oral clarithromycin and para-aminosalicylic acid - intravenous ceftriaxone, oral ciprofloxacin - exenteratio | exenterated |
51 | Pittenger, BMJ | S. aureus | N/A | 0 | - intravenous vancomycin - intravitreal vancomycin and ceftazidime | N/A |
52 | Fortun, Ophthal Surg Las | S. aureus (all) | N/A | 0 | - systemic vancomicyn and gentamicin | N/A |
0; 1 | 0; 0 | - intravitreal vancomicyn and foscarnet - systemic trimetoprim-sulphametoxazole | RE same VA; LE better VA | |||
1 | 0.4 | - intravitreal vancomycin and ceftazidime - systemic vancomycin | better VA | |||
1.7 | 1.7 | - intravitreal vancomycin, ceftazidime and foscarnet - systemic trimethoprim-sulfamethoxazole and foscarnet | same VA | |||
0; 1.7 | 0; 0 | - intravitreal vancomycin - systemic vancomycin | RE same VA; LE better VA | |||
0.5; 1.9 | 0.6; 1.2 | - intravitreal vancomycin and ceftazidime - systemic trimethoprim-sulfamethoxazole and vancomycin | ||||
N/A; N/A | 1.2; 3 | - intravitreal vancomycin and ceftazidime - systemic vancomycin - RE vitrectomy + buckling + silicone oil | N/A | |||
53 | Oduard, Clin Exp Ophthalmol | Klebsiella P. Klebsiella P. | 1.9 | 0.5 | - intravitreal ceftazidime × 2 and vancomycin - intravenous ceftriaxone - topical prednisolone and phenylephrine - vitrectomy + SRA drainage + silicone oil | better VA |
0.3; 2.3 | 0.3; 0.6 | - BE intravitreal vancomycin and ceftazidime: RE × 4 and LE × 5 - BE intravitreal dexamethasone: RE × 4 and LE × 5 - intravenous ceftriaxone - oral steroid - BE topical steroid - RE 1st vitrectomy - RE 2nd vitrectomy + SRA drainage + silicone oil - LE vitrectomy + SRA drainage + silicone oil | RE same VA; LE better VA | |||
54 | Pappuru, Int Ophthalmol | Mycobacterium TB | 1.8 | 0.3 | - ATT - oral steroids | better VA |
55 | Bendhe, J Ophthal Inflamm Infect | Roseomonas Mucosa | 1.9 | 1.3 | - 2 x intravitreal ceftazidime and vancomycin - oral cefotaxime - topical moxifloxacin, tobramycin, homatropine and prednisolone - vitrectomy + SRA drainage + silicone oil | better VA |
56 | Dutta-Majumder, Ocul Imm Inflamm | Mycobacterium TB (all) | 0.8 | 0.5 | ATT, topical and oral steroid | better VA |
1.9 | 1.3 | ATT, topical steroid | better VA | |||
1.5 | 1.8 | ATT, periocular steroid | worse VA | |||
2.7 | 0.5 | ATT, topical and oral steroid | better VA | |||
1.9 | 0.2 | ATT, topical steroid | better VA | |||
2.7 | 2.7 | ATT, topical and oral steroid | same VA | |||
1.9 | 1.9 | ATT, topical and oral steroid | same VA | |||
1.5 | 1.9 | ATT, topical and oral steroid | worse VA | |||
0.8 | 0 | ATT, topical steroid | better VA | |||
1.9 | 0.5 | ATT, topical and oral steroid | better VA | |||
0.5 | 2.7 | ATT, topical and periocular steroid | worse VA | |||
1.9 | 1.0 | ATT, oral steroid | better VA | |||
57 | Harvey, BMJ Cas rep | S. aureus | 2.3 | 1.9 | - intravenous flucloxacillin and ceftriaxone - topical steroid - oral antibiotics (not specified) | better VA |
58 | Prajapati, BMJ Cas Rep | S. aureus | 2.3 | 1.0 | - intravenous clindamycin, meropenem, flucloxacillin, ganciclovir - oral pyrimethamine | better VA |
59 | Zafar, BMC Res Not | Candida A. | 1.9 | N/A | - intravitreal amphotericin - vitrectomy + intravitreal amphotericin - oral voriconazole | N/A |
60 | Chawla, Middle East Afr J Ophthalmol | Mycobacterium TB | 1; 1.8 | 0.3; 1.5 | - oral ATT (isoniazid, rifampicin, ethambutol, and pyrazinamide) - topical steroid and cycloplegic | BE better VA |
61 | Puri, Am J Ophthalmol | Nocardia Farcinica | N/A | 0.7 | - intravenous vancomycin, piperacillin-tazobactam and micafungin - intravitreal amikacin - oral bactrim and augmentin | N/A |
62 | Xu, BMC Ophthalmol | Nocardia | 1.9 | 1.0 | - intravitreal vancomycin and ceftazidime - topical levofloxacine and steroids - oral trimethoprim and sulfamethoxazole + oral prednisone | better VA |
63 | Tran, Clin Exp Ophthal | Nocardia Farcinica | 0.5 | – | - systemic moxifloxacin, voriconazole and amphotericin - intravitreal multiple injections of voriconazole, vancomicin, ceftazidime and foscarnet - evisceratio | eviscerated |
64 | Scavelli, Am J Cas Rep | Nocardia Farcinica | 1.9 | 0.3 | - systemic sulfamethoxazole/trimethoprim and imipenem - intravitreal amikacin × 4 | better VA |
65 | Manoharam, JRSM Open | Proteus Mirabilis, Enterococcus Faecium, E. coli | 1.9 | 1.9 | - intravitreal vancomicin × 2, ceftazidime × 2 - topical antibiotics, steroid and cycloplegic drops - oral antibiotics (not specified) - intravenous linezolid, meropenem and fluconazole | same VA |
66 | Mohd-Ilham, Cureus | Klebsiella P. | 1.0 | 0.8 | - intravenous cefepime and ciprofloxacin - intravitreal vancomycin and ceftazidime - topical cefuroxime, gentamicin and dexamethasone) - vitrectomy + silicone oil | better VA |
67 | Angermann, Ocul Imm Inflamm | Nocardia Cyriacigeorgica | N/A | N/A | - vitrectomy + SRA biopsy - systemic trimethoprim-sulfamethoxazole | N/A |
3.1.4.68 | Dogra, Ocul Imm Inflamm | Klebsiella P. | 1.9 | 0.8 | - intravitreal vancomycin and ceftazidime - topical moxifloxacin, prednisolone and cycloplegics - intravenous piperacillin/tazobactam - intravitreal piperacillin/tazobactam + dexamethasone | better VA |
69 | Yiesiltas, Ocular Imm Inflamm | Candida A. | 1.9 | 1.9 | - oral methylprednisone + co-trimoxazole - intravenous amphotericin - topical steroid and cyclopentolate - intravitreal voriconazole and amphotericin - oral fluconazole - vitrectomy + silicone oil | same VA |
70 | Shen, Retina | Klebsiella P. | 2.3 | 2.3 | - intravitreal vancomycin | same VA |
71 | Hojjatie, J Ophthalmic Inflamm Infect | Nocardia Farcinica | 1.2 | 0.7 | - intravitreal voriconazole, vancomycin and amikacin - topical steroids and cycloplegics - vitrectomy | better VA |
72 | Vamsidhar, J R Coll Physicians Edinb | S. aureus | 1.3; 1.8 | 0.5; 0.5 | - intravenous ceftazidime, vancomycin and cloxacillin - oral ATT - oral cloxacillin | BE better VA |
73 | Lim, Case Rep Ophthalmol Med | Klebsiella P. | 2.3 | 1.0 | - intravenous ceftriaxone, metronidazole and amikacin - intravitreal vancomycin × 1, ceftazidime × 9 and dexamethasone × 4 - topical antibiotics - vitrectomy + intravitreal ceftazidime | better VA |
not isolated | 1.9 | 2.3 | - oral moxifloxacin, intravenous ceftriaxone, amikacin and metronidazole - intravitreal vancomicin, ceftazidime, ceftriaxone and dexamethasone - vitrectomy + intravitreal ceftriaxone and vancomycin | better VA | ||
74 | Nair, Indian J Ophthalmol | Mycobacterium TB | 1.9 | 0.4 | - oral ATT (isoniazid, rifampicin, ethambutol and pyrazinamide) - steroids | better VA |
75 | Kapoor, Indian J Ophthalmol | not isolated | 2.7 | 1.0 | - intravenous ceftriaxone - intravitreal vancomicin, piperacillin and amphotericin - vitrectomy | better VA |
76 | Malik, BMJ Cas Rep | Nocardia | 0.7 | 0.7 | - intravitreal amikacin, vancomicin and amphotericin - intravenous amikacin and imipenem - oral trimethoprim-sulfamethoxazole and linezolid - vitrectomy | same VA |
77 | Fan, Ret Cas Brief Rep | Klebsiella P. | 2.3 | N/A | - vitrectomy + phaco + AC washout + intravitreal ceftazidime, vancomicine and amikacin - intravenous vancomicin and cefepime - enucleation | enucleated |
78 | Cunha, Ret Cas Brief Rep | Nocardia Abscessus | 0.4 | 0.3 | - systemic trimetoprim-sulfalethoxazol, imipenem and cefipime - intravitreal bevacizumab | better VA |