Endophthalmitis Defensin Study
Research type
Research Study
Full title
MULTICENTRIC POPULATION CASE-CONTROL STUDY OF SPECIFIC HUMAN BETA-DEFENSIN 1 GENOTYPE IN PATIENTS WITH ENDOPHTHALMITIS FOLLOWING A VARIETY OF INTRA-OCULAR PROCEDURES VS CONTROLS
IRAS ID
145301
Contact name
Richard Haynes
Contact email
Sponsor organisation
University Hospitals Bristol NHS Foundation Trust
Duration of Study in the UK
0 years, 11 months, 27 days
Research summary
Endophthalmitis is a rare but devastating infectious complication that can occur following eye surgery. It often results in severe loss of vision and sometimes loss of the eye. It can occur after cataract surgery, eye (intra-vitreal) injections, retinal surgery (vitrectomy) and after other types of intra-ocular surgery.
Previous studies have investigated environmental risk factors for endophthalmitis (for example, surgical complications increase the risk of endophthalmitis after cataract surgery). Only one study has previously investigated the role of genetic risk factors, and this was a relatively small pilot study and related to cataract surgery only. This study found that an abnormal defensin gene profile significantly increases the risk of endophthalmitis.
We aim to test whether a specific defensin genetic profile is associated with endophthalmitis following a range of intraocular procedures.
This study will improve patient care in 4 ways. Firstly, it will allow improved informed consent since pre-operative genetic testing (now simple and cost effective) will establish if a patient has an increased genetic risk for endophthalmitis. This will allow the patient to consider non-surgical options if appropriate or to defer surgery until the need for surgery is greater.
Secondly, it will improve post-operative care. Patients with an at-risk genotype justify closer post-operative review, so if they develop endophthlamitis this is detected and managed at an earlier stage, resulting in an improved outcome.
Thirdly, it will alert patients and doctors to consider avoidance of simultaneous bilateral intervention (commonly done for eye injections for age related macular degeneration, and less commonly cataract surgery). Simultaneous bilateral endophthalmitis would be totally devastating.
Fourthly, it would justify targeted anti-biotic prophylaxis (prevention) for patients with an increased genetic risk of endophthalmitis. It is otherwise costly and clinically inappropriate to regularly use powerful broad-spectrum anti-biotics for all patients, since this would encourage anti-microbial resistance (“super-bugs”).
REC name
South West - Central Bristol Research Ethics Committee
REC reference
16/SW/0011
Date of REC Opinion
5 Apr 2016
REC opinion
Further Information Favourable Opinion