<i>Klebsiella pneumoniae</i> Endophthalmitis with Subretinal Abscess: A Case Series and Review of the Literature

This study assessed prognostic factors and the role of vitrectomy in patients with subretinal abscesses secondary to <i>K. pneumoniae</i> endophthalmitis. We reviewed published studies, including three cases from our cohort. Among 50 eyes, 26 had poor visual outcomes (final visual acuity &lt;20/800, eyeball removal, or phthisis bulbi). Poor outcomes correlated with delayed ocular symptom-to-diagnosis time, initial visual acuity &lt;20/800, severe vitritis, and macular involvement of abscesses (<i>p</i> &lt; 0.001, <i>p</i> = 0.008, <i>p</i> &lt; 0.001, and <i>p</i> = 0.033, respectively). Vitrectomy had a trend towards reducing eyeball removal and phthisis bulbi rates compared with non-vitrectomy (10.8% vs 30.8%, <i>p</i> = 0.181). However, the final visual acuity was not different and the rate of retinal detachment tended to be higher in vitrectomized eyes (45.9% vs 15.4%, <i>p</i> = 0.095). The study suggested that vitrectomy and drainage of <i>K. pneumoniae</i> subretinal abscesses could be avoided in patients with a mild degree of vitritis.