| domain | knowledge-base statement | suggested ontology terms/IDs | evidence type |
|---|---|---|---|
| Disease definition | Endophthalmitis is a severe intraocular infection/inflammation involving ocular fluids and tissues; major clinical forms are exogenous (postoperative, post-injection, post-traumatic) and endogenous (hematogenous spread). (pqac-00000004, pqac-00000011) | MONDO: term-name-only suggestion `endophthalmitis` (exact MONDO ID uncertain); MeSH: `Endophthalmitis` (term-name-only); ICD-10: H44.0 `Purulent endophthalmitis`, H44.1 `Other endophthalmitis` | Human clinical cohorts; systematic review |
| Resource provenance | Most knowledge here is aggregated disease-level evidence from cohorts, systematic reviews, guidelines, and model-organism studies rather than individual-patient EHR alone. (pqac-00000001, pqac-00000011, pqac-00000014) | Evidence provenance annotation: aggregated disease-level resource | Mixed evidence synthesis |
| Classification | Exogenous disease predominates overall; endogenous disease is a minority but clinically important subtype. In a German state study, only 7.9% were endogenous; in an Australian cohort, 87.1% were exogenous. (pqac-00000013, pqac-00000004) | Disease subtypes: `exogenous endophthalmitis` (term-name-only), `endogenous endophthalmitis` (term-name-only) | Human epidemiology |
| Disease timing | Presentation is usually acute/subacute after ocular procedures; median time to presentation was 5 days post-procedure in one 18-year cohort. (pqac-00000005) | HPO term-name-only suggestions: `Acute onset`, `Abnormality of vision`; temporal annotation: acute/subacute | Human cohort |
| Phenotype | Reduced visual acuity is a core presenting feature and major prognostic marker. (pqac-00000007, pqac-00000010) | HPO: `Decreased visual acuity` (exact ID not asserted) | Human cohort; case report |
| Phenotype | Ocular pain is common, especially in endogenous fungal or bacterial presentations. (pqac-00000008, pqac-00000009) | HPO term-name-only: `Eye pain` | Human case reports |
| Phenotype | Red eye/conjunctival injection is a typical inflammatory manifestation. (pqac-00000008, pqac-00000009) | HPO term-name-only: `Red eye` | Human case reports |
| Phenotype | Vitritis/vitreous opacity is a hallmark sign and often limits retinal visualization. (pqac-00000009, pqac-00000010) | HPO term-name-only: `Vitritis`, `Vitreous haze` | Human case reports |
| Phenotype | Hypopyon/anterior chamber reaction occurs in severe bacterial cases. (pqac-00000008, pqac-00000010) | HPO term-name-only: `Hypopyon`, `Anterior chamber inflammation` | Human case reports |
| Phenotype | Floaters and photophobia may occur in endogenous disease. (pqac-00000010) | HPO term-name-only: `Floaters`, `Photophobia` | Human case report |
| Complications | Severe outcomes include retinal damage, retinal detachment/PVR after surgery, secondary glaucoma, enucleation, and permanent vision loss. (pqac-00000009, pqac-00000007) | HPO term-name-only: `Retinal detachment`, `Secondary glaucoma`, `Blindness` | Human case report; cohort |
| Anatomy | Primary affected compartments are vitreous body and aqueous/anterior chamber, with spread to retina and choroid; fungal disease may persist at ciliary processes and posterior lens surface. (pqac-00000009, pqac-00000010) | UBERON term-name-only: `vitreous humor`, `anterior chamber of eyeball`, `retina`, `choroid`, `ciliary body`, `lens` | Human pathology/case reports |
| Localization | Endogenous cases may show retinochoroidal abscess/chorioretinal involvement. (pqac-00000008) | UBERON/HPO term-name-only: `retinochoroidal abscess`, `chorioretinal lesion` | Human imaging/case report |
| Etiology | Exogenous causes include cataract surgery, intravitreal injection, vitrectomy, glaucoma surgery, and penetrating trauma/IOFB. (pqac-00000000, pqac-00000016) | Exposure annotations: `cataract surgery`, `intravitreal injection`, `penetrating eye injury`, `intraocular foreign body` | Human cohort |
| Etiology | Endogenous disease results from hematogenous dissemination during systemic infection; associated settings include bacteremia, infective endocarditis, urinary tract infection, diabetes, immunosuppression, and indwelling catheters. (pqac-00000011, pqac-00000012, pqac-00000010) | Disease/exposure term-name-only: `bacteremia`, `infective endocarditis`, `urinary tract infection`, `immunosuppression`, `diabetes mellitus` | Systematic review; cohort; case report |
| Pathogens | Gram-positive cocci predominate overall; `Staphylococcus epidermidis` is the most common organism in multiple cohorts. (pqac-00000000, pqac-00000006) | NCBI Taxonomy term-name-only: `Staphylococcus epidermidis`, `Staphylococcus aureus`, `Enterococcus faecalis` | Human microbiology cohorts |
| Pathogens | Other important bacteria include streptococci, `Pseudomonas aeruginosa`, `Escherichia coli`, and hypervirulent `Klebsiella pneumoniae`. (pqac-00000001, pqac-00000008, pqac-00000010) | NCBI Taxonomy term-name-only: `Streptococcus spp.`, `Pseudomonas aeruginosa`, `Escherichia coli`, `Klebsiella pneumoniae` | Human cohort; case reports |
| Pathogens | Fungal causes include `Candida albicans`, `Aspergillus spp.`, and rare dematiaceous fungi such as `Cladophialophora devriesii`; fungi are relatively more important in endogenous disease. (pqac-00000011, pqac-00000009, pqac-00000013) | NCBI Taxonomy term-name-only: `Candida albicans`, `Aspergillus spp.`, `Cladophialophora devriesii` | Systematic review; case report; cohort |
| Epidemiology | Post-cataract and post-injection disease are currently dominant exogenous forms; one Australian cohort found both accounted for 38.1% each among all cases. (pqac-00000005) | Epidemiology annotation only | Human cohort |
| Epidemiology | Post-injection endophthalmitis risk in one anti-VEGF era cohort was approximately 0.035% (about 1 in 2,857 injections). (pqac-00000003) | Epidemiology annotation only | Human cohort |
| Risk factor | Metallic intraocular foreign body correlates with faster symptom onset and poorer control after vitrectomy. (pqac-00000016, pqac-00000006) | Exposure term-name-only: `intraocular foreign body` | Human cohort |
| Risk factor | In infective endocarditis patients, diabetes, alcohol use disorder, cirrhosis, and older age increased endogenous endophthalmitis risk. (pqac-00000012) | Disease/exposure term-name-only: `diabetes mellitus`, `alcohol use disorder`, `cirrhosis`, `advanced age` | Human database study |
| Protective factor | In a national post-injection study, non-smoking was protective. (pqac-00000003) | Exposure term-name-only: `non-smoker status` | Human epidemiology |
| Immune mechanism | Disease pathogenesis involves rapid innate immune activation with neutrophil infiltration, inflammatory cytokines, and retinal tissue injury. (pqac-00000014, pqac-00000015) | GO term-name-only: `neutrophil migration`, `inflammatory response`, `cytokine-mediated signaling pathway`; CL term-name-only: `neutrophil` | Murine model; translational |
| Immune mechanism | Key inflammatory mediators elevated in bacterial endophthalmitis include IL-1β, TNF-α, IL-6, and CXCL2. (pqac-00000014) | GO term-name-only: `interleukin-1 production`, `tumor necrosis factor production`, `interleukin-6 production`, `chemokine production` | Murine model |
| Immune mechanism | Macrophage phenotype influences outcome; myeloid AMPKα1 supports infection resolution, whereas deletion skews toward inflammatory M1 macrophages and impairs phagocytic clearance. (pqac-00000014) | GO term-name-only: `macrophage activation`, `phagocytosis`, `response to bacterium`; CL term-name-only: `macrophage`, `monocyte` | Murine model |
| Immune mechanism | Fungal endophthalmitis transcriptomics showed enriched T-cell signaling, NK-cell mediated cytotoxicity, C-type lectin receptor signaling, and NOD-like receptor signaling. (pqac-00000015) | GO/Pathway term-name-only: `T cell activation`, `natural killer cell mediated immunity`, `pattern recognition receptor signaling pathway`, `NOD-like receptor signaling pathway` | Murine transcriptomics |
| Molecular profiling | In murine `Candida albicans` endophthalmitis, 1,493 significant DEGs were reported (924 upregulated, 569 downregulated). (pqac-00000015) | Omics annotation only | Murine RNA-seq |
| Molecular profiling | Extracellular-vesicle miR-223-3p is linked to modulation of the NLRP3 inflammasome and may have biomarker potential in culture-negative bacterial disease. (pqac-00000014) | GO term-name-only: `inflammasome complex assembly`; molecular entities: `miR-223-3p`, `NLRP3` | Murine + human vitreous translational study |
| Cell types | Major involved cells include neutrophils, monocytes/macrophages, retinal immune cells, T cells, and NK cells. (pqac-00000014, pqac-00000015) | CL term-name-only: `neutrophil`, `monocyte`, `macrophage`, `T cell`, `natural killer cell`, `retinal Müller glial cell` (supportive literature context) | Murine model |
| Diagnostics | Core microbiology remains vitreous/aqueous sampling with Gram stain/culture plus molecular testing; no single method detects all cases. (pqac-00000000, pqac-00000013) | Diagnostic procedure term-name-only: `vitreous tap`, `aqueous tap`, `microbial culture`, `broad-range PCR` | Human cohort |
| Diagnostics | Culture positivity is incomplete: 58.7% in one German series and 44.0% in one Chinese series. (pqac-00000000, pqac-00000006) | Laboratory finding annotation only | Human cohorts |
| Diagnostics | Metagenomic sequencing is an emerging adjunct for infectious uveitis/endophthalmitis workups, especially when culture/PCR are negative or limited. (pqac-00000002) | Diagnostic procedure term-name-only: `metagenomic sequencing`, `mNGS` | Review/technology assessment |
| Imaging | B-scan ultrasonography can identify vitritis and retinochoroidal abscess when the fundus view is obscured. (pqac-00000008, pqac-00000010) | Imaging term-name-only: `B-scan ultrasonography` | Human case reports |
| Differential diagnosis | Important mimics include noninfectious uveitis and vitreoretinal lymphoma; distinguishing infection is clinically critical. (pqac-00000002) | Disease term-name-only: `uveitis`, `vitreoretinal lymphoma` | Review/contextual expert synthesis |
| Treatment | Standard empiric bacterial therapy remains intravitreal vancomycin plus ceftazidime; intravitreal antibiotics were used in 97.3% of cases in one large cohort. (pqac-00000007, pqac-00000004) | NCIT term-name-only: `Intravitreal Injection`, `Vancomycin`, `Ceftazidime` | Human cohort; expert-standard practice |
| Treatment | Pars plana vitrectomy is frequently used for severe disease, diagnostic sampling, or poor initial vision; one cohort reported vitrectomy in 41.5% of cases, and benefit appears greatest in light-perception presentations. (pqac-00000001, pqac-00000004) | NCIT term-name-only: `Vitrectomy`, `Pars Plana Vitrectomy` | Human cohort; EVS-aligned expert practice |
| Treatment | Fungal disease often requires combined local and systemic antifungal therapy, with cases using amphotericin B, voriconazole, posaconazole, itraconazole, or isavuconazole. (pqac-00000009) | NCIT term-name-only: `Amphotericin B`, `Voriconazole`, `Posaconazole`, `Itraconazole`, `Isavuconazole` | Human case report |
| Treatment outcomes | Visual improvement is common but incomplete; one cohort found 52.5% improved, while presenting BCVA strongly predicts final outcome. (pqac-00000001, pqac-00000007) | Outcome annotation only | Human cohorts |
| Prevention | Intracameral antibiotic prophylaxis after cataract surgery is a major preventive strategy; modern post-cataract rates are substantially lower than historical ~0.13%–0.15%. (pqac-00000006) | NCIT term-name-only: `Antibiotic Prophylaxis`, `Intracameral Administration` | Editorial/surveillance synthesis |
| Prevention | Peri-procedural sterile protocols and microbiological surveillance are central to prevention, especially as post-injection cases rise with anti-VEGF use. (pqac-00000003, pqac-00000004) | Public health/clinical process annotation only | Human cohort |
| Genetics | No established Mendelian causal gene defines infectious endophthalmitis as a disease entity. | N/A for causal Mendelian genes | Not applicable |
| Inheritance | No Mendelian inheritance pattern applies; susceptibility is primarily infectious/procedural/systemic-risk based rather than inherited as a monogenic disorder. | N/A for AD/AR/X-linked inheritance | Not applicable |
| Pathogenic variants | No disease-defining germline pathogenic variant set is established for endophthalmitis. | N/A for variant annotation | Not applicable |
| Genetic testing | Routine clinical genetic testing (single-gene, panel, WES/WGS, CMA, FISH, mtDNA, repeat expansion) is not standard for diagnosis of infectious endophthalmitis. | N/A for genetic testing workflow | Not applicable |
| Model organisms | Mouse intravitreal infection models are widely used for bacterial and fungal pathogenesis and treatment studies. (pqac-00000014, pqac-00000015) | Model annotation only | Model organism |
| Model organisms | Zebrafish are comparatively resistant to `Staphylococcus aureus` endophthalmitis and may model protective innate responses rather than full human disease severity. (pqac-00000005) | Model annotation only | Model organism |
| Comparative limitation | Animal models reproduce inflammatory and microbiological features but may not fully capture human procedure-related heterogeneity, chronicity, or visual outcome trajectories. (pqac-00000014, pqac-00000015) | Evidence limitation annotation | Model-based inference |


*Table: This table condenses clinically and biologically relevant endophthalmitis facts into ontology-ready statements with suggested term mappings and evidence types. It is designed to help populate a disease knowledge base while clearly marking uncertain IDs and non-applicable Mendelian genetics fields.*