Basic principles in treatment of endophthalmitis

The therapy of infectious endophthalmitis remain a controversial issue because progression and suboptimal outcome occur despite bacteriologic cure of the intraocular infection. The irreversible tissue destruction during the inflammatory process may result largely from a secondary host inflammatory response. However, adjunctive treatment with immunosuppressive agents may interfere with the ability of the immune system to eliminate the microorganisms. We discuss diagnostic means, therapy and options of adjunctive immunosuppression in the therapy of infectious endophthalmitis. Furthermore, we report on our clinical experience in patients with endogenous and exogenous infectious bacterial and mycotic endophthalmitis with combined treatment using high doses of steroids.