Dev S, Pulido J S, Tessler H H, Mittra R A, Han D P, Mieler W F, Connor T B
Medical College of Wisconsin Eye Institute, Vitreoretinal Section, Milwaukee 53226, USA.
Ophthalmology. 1999 Apr;106(4):774-81. doi: 10.1016/S0161-6420(99)90166-5.
To determine the effect of endophthalmitis on diabetic retinopathy.
Noncomparative case series.
The records of all consecutive patients with endophthalmitis treated between 1992 and 1997 at the Medical College of Wisconsin were retrospectively reviewed. Those patients with diabetes mellitus were analyzed.
From 77 reviewed records, 11 patients (12 eyes; 14%) were identified as diabetics with endophthalmitis and were studied.
Stage of diabetic retinopathy, time to retinopathy progression, and visual acuity.
Mean patient age was 68 years, and mean duration of diabetes was 11.7 years. Mean patient follow-up was 17 months. Of the six cases without evidence of retinopathy before the endophthalmitis, none went on to develop retinopathy. Of six eyes with pre-existing nonproliferative retinopathy, four showed evidence of progression within 6 months of the infection. Three developed severe proliferative disease and macular edema, and one developed severe nonproliferative disease. More patients without pre-existing retinopathy achieved a final visual acuity of 20/40 or greater.
Patients with pre-existing diabetic retinopathy may be at increased risk for rapid retinopathy progression and a poorer visual outcome after endophthalmitis. These results support the concept that inflammation may exacerbate diabetic retinopathy.
确定眼内炎对糖尿病性视网膜病变的影响。
非对照病例系列。
回顾性分析1992年至1997年在威斯康星医学院接受治疗的所有连续性眼内炎患者的病历。对那些患有糖尿病的患者进行分析。
在77份回顾性病历中，确定11例（12只眼；14%）患有眼内炎的糖尿病患者并进行研究。
糖尿病性视网膜病变的分期、视网膜病变进展时间和视力。
患者平均年龄为68岁，糖尿病平均病程为11.7年。患者平均随访时间为17个月。在眼内炎发生前无视网膜病变证据的6例患者中，无一例发生视网膜病变。在6只已有非增殖性视网膜病变的眼中，4只在感染后6个月内出现进展迹象。3只眼发展为严重增殖性疾病和黄斑水肿，1只眼发展为严重非增殖性疾病。更多在眼内炎发生前无视网膜病变的患者最终视力达到20/40或更好。
已有糖尿病性视网膜病变的患者在发生眼内炎后，视网膜病变快速进展的风险可能增加，视力预后可能更差。这些结果支持炎症可能会加重糖尿病性视网膜病变这一观点。
