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

Study Overview

• Status: Completed
• Conditions: Endophthalmitis
• Intervention / Treatment: Procedure: Early pars plana vitrectomy (PPV) with intravitreal antibiotics

• Study Type: Observational
• Enrollment (Actual): 170

Contacts and Locations

Study Locations

• France
  • Brest, France, 29200
    • CHU Brest

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This retrospective cohort includes adult patients diagnosed with acute endophthalmitis and managed at two referral centers (University Hospital of Brest and Pasteur Clinic, France) between January 2014 and December 2024. Patients were identified using International Classification of Diseases, 10th Revision (ICD-10) codes and included a broad spectrum of etiologies (postoperative, post-intravitreal injection, traumatic, bleb-related, and endogenous endophthalmitis), reflecting real-world clinical practice.

Description

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

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Best-corrected visual acuity (BCVA) measured in logarithm of the minimum angle of resolution (logMAR) at 1 month	Best-corrected visual acuity (BCVA), measured using the logarithm of the minimum angle of resolution (logMAR) scale, assessed at 1 month after diagnosis of acute endophthalmitis.	1 month after diagnosis of acute endophthalmitis

Collaborators and Investigators

• Sponsor: University Hospital, Brest

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2025
• Primary Completion (Actual): December 31, 2025
• Study Completion (Actual): December 31, 2025

Study Registration Dates

• First Submitted: March 31, 2026
• First Submitted That Met QC Criteria: March 31, 2026
• First Posted (Actual): April 7, 2026

Study Record Updates

• Last Update Posted (Actual): April 21, 2026
• Last Update Submitted That Met QC Criteria: April 16, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Infections; Eye Diseases; Eye Infections; Endophthalmitis; Health Care Quality, Access, and Evaluation; Investigative Techniques; Epidemiologic Research Design; Epidemiologic Methods; Health Care Evaluation Mechanisms; Quality of Health Care; Public Health; Environment and Public Health; Sensitivity and Specificity; Predictive Value of Tests
• Other Study ID Numbers: 29BRC25.0153 - BRESTE

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: All collected data that underlie results in a publication
• IPD Sharing Time Frame: Data will be available beginning three years and ending fifteen years following the final study report completion
• IPD Sharing Access Criteria: Data access requests will be reviewed by the internal committee of Brest UH. Requestors will be required to sign and complete a data access agreement
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No