Diagnosis of Endophthalmitis with amplification of syndrome specific signature genes by Syndrome Evaluation System: A Retrospective Analysis

Abstract

Background: To evaluate the microbiological concordance of clinically diagnosed endophthalmitis cases using isolation of genetic material of the causative agent from either aqueous or vitreous fluid and simultaneous amplification of syndrome specific signature genes.Methods: Thirteen cases clinically diagnosed as endophthalmitis at tertiary centre of  Vitreo-Retina care, in whom isolation of genetic material of the causative agent from either aqueous or vitreous fluid and simultaneous amplification of syndrome specific signature genes termed as Syndrome evaluation system (SES)  was carried out were included in this retrospective analysis. The vitrectomy samples or Aqueous taps were sent to  for  SES analysis and results were obtained within 24 hours of vitrectomy and results considered  for deciding treatment.  Results: 7 out of 13 cases were positive for bacteria or fungi or virus  when tested on SES. Out of Seven positive two were also culture positive and concordant.  Three out of these seven positives did not improve in visual acuity while two cases improved and in two cases there was deterioration in visual acuity noted. Six out of the 13 cases SES did not detect any organisms. It can also be seen that 5 out of six negatives improved in visual acuity with treatment.Conclusion: SES was an accurate, quick and reliable diagnostic method in endophthalmitis whose sensitivity was much higher than culture and Gram’s staining. This diagnostic technique can help in administering targeted therapies at a much earlier stage and hence improve the overall outcome of the endophthalmitis cases.