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玻璃体切除术对改善蜡样芽孢杆菌性眼内炎结局的疗效。

Efficacy of vitrectomy in improving the outcome of Bacillus cereus endophthalmitis.

机构信息

Department of Ophthalmology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma 73104, USA.

出版信息

Retina. 2011 Sep;31(8):1518-24. doi: 10.1097/IAE.0b013e318206d176.

Abstract

PURPOSE

To evaluate the efficacy of vitrectomy with vancomycin for the treatment of experimental Bacillus cereus endophthalmitis.

METHODS

Endophthalmitis was initiated in rabbits via intravitreal injection of 100 colony-forming unit B. cereus. Treatment groups included 25-gauge transconjunctival sutureless vitrectomy with intravitreal vancomycin (1 mg) or vancomycin alone. Groups were treated at 4, 5, or 6 hours after infection. At 48 hours (for 4-hour and 5-hour groups) or 36 hours (for the 6-hour group) after infection, eyes were analyzed by electroretinography, histology, and inflammatory cell counts.

RESULTS

Treatment with vitrectomy/vancomycin at 4 hours resulted in significantly greater retinal function compared with that of vancomycin alone. Intraocular inflammation after treatment at 4 hours was minimal for both the treatment groups. Treatment with vitrectomy/vancomycin or vancomycin alone at 5 hours or 6 hours after infection resulted in similar levels of retinal function loss (i.e., >90%) and significant intraocular inflammation.

CONCLUSION

These results demonstrate that vitrectomy may be of therapeutic benefit in the treatment of B. cereus endophthalmitis but only during the early stages of infection.

摘要

目的

评估玻璃体内注射万古霉素治疗实验性蜡状芽孢杆菌眼内炎的疗效。

方法

通过玻璃体内注射 100 个菌落形成单位的蜡状芽孢杆菌在兔子中引发眼内炎。治疗组包括 25 号经结膜无缝线玻璃体切除术联合玻璃体内万古霉素(1 毫克)或万古霉素单独治疗。感染后 4、5 或 6 小时进行治疗。感染后 48 小时(4 小时和 5 小时组)或 36 小时(6 小时组),通过视网膜电图、组织学和炎症细胞计数对眼睛进行分析。

结果

在 4 小时时用玻璃体切除术/万古霉素治疗,与单独使用万古霉素相比,视网膜功能明显更好。两组治疗后的眼内炎症均很少。在感染后 5 小时或 6 小时用玻璃体切除术/万古霉素或万古霉素单独治疗,导致视网膜功能丧失(即>90%)和明显的眼内炎症相似。

结论

这些结果表明,玻璃体切除术可能对治疗蜡状芽孢杆菌眼内炎具有治疗益处,但仅在感染的早期阶段。

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