伴有眼眶体征的眼内炎：病例对照研究。

Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18 College Road, Chennai 600006, Tamil Nadu, India.

Retina. 2010 Mar;30(3):491-4. doi: 10.1097/IAE.0b013e3181bced7f.

PURPOSE

The purpose of this study was to assess the clinical profile and treatment outcomes in eyes with endophthalmitis presenting with orbital signs.

METHODS

A case-control study of 24 eyes with endophthalmitis and orbital signs at presentation (defined as ocular motility restriction and/or presence of " inverted perpendicular" sign on ultrasonography) was conducted between January 2000 and December 2006. The control group was constituted of 40 age- and sex-matched eyes with endophthalmitis presenting without orbital signs. Optimal structural outcome was defined as resolution of inflammation and infection. Adverse structural outcome was defined as development of phthisis bulbi or need for evisceration or development of retinal detachment. Optimal functional outcome was defined as improvement in postoperative visual acuity to 3/60 or better. The Pearson chi-square test was used with appropriate significance (P < or = 0.05) to compare the mean visual acuity before and after treatment.

RESULTS

Twenty-four patients with a mean age of 46.4 years and a mean follow-up of 14.6 months were included. Treatment options included intravitreal antibiotics, vitrectomy, evisceration, and systemic antibiotics. Optimal structural outcome was achieved in 6 (25%) eyes. A total of 70.8% eyes had no light perception, whereas 4 (16.66%) patients regained ambulatory vision (>3/60). There was a statistically significant poor visual (P = 0.05) and structural outcome (P = 0.004), whereas in the control group, 25 patients (62.5%) had vision 3/60 or better (P = 0.001).

CONCLUSION

Orbital signs are independent risk factors for poor structural and visual outcomes in eyes with endophthalmitis.

目的

本研究旨在评估以眼眶体征为首发表现的眼内炎的临床特征和治疗结果。

方法

对 2000 年 1 月至 2006 年 12 月期间就诊的 24 例以眼眶体征（定义为眼球运动受限和/或超声检查存在“倒置垂直”征）为首发表现的眼内炎患者（病例组）和 40 例无眼眶体征的眼内炎患者（对照组）进行病例对照研究。最佳结构结局定义为炎症和感染的消退。不良结构结局定义为眼球萎缩、眼内容剜除或视网膜脱离的发生。最佳功能结局定义为术后视力提高至 3/60 或更佳。采用 Pearson 卡方检验（P≤0.05 有统计学意义）比较治疗前后的平均视力。

结果

24 例患者的平均年龄为 46.4 岁，平均随访时间为 14.6 个月。治疗方法包括玻璃体内抗生素、玻璃体切除术、眼内容剜除术和全身抗生素治疗。6 只眼（25%）达到最佳结构结局。70.8%的眼无光感，而 4 只眼（16.66%）患者恢复了行动视力（>3/60）。视力（P=0.05）和结构结局（P=0.004）均有统计学意义较差，而对照组中 25 例（62.5%）患者视力为 3/60 或更佳（P=0.001）。