Department of Ophthalmology, Gifu University Graduate School of Medicine, Japan.
Acta Ophthalmol. 2013 Sep;91(6):e420-6. doi: 10.1111/aos.12079. Epub 2013 Jul 2.
To identify changes in visual acuity and intra-ocular pressure (IOP) 12 months after the development of bleb-related infection.
Data obtained from 146 eyes of 146 patients with bleb-related infection were analyzed as a part of the Japan Glaucoma Society Survey of Bleb-related Infection. Multiple logistic regression analysis was conducted to identify factors associated with poor prognosis in visual acuity and increased IOP and for being stage III.
The logMAR increased by a mean of 0.140, 0.440, 1.099 and 1.122 at 12 months postinfection for stage I, II, IIIa and IIIb infections, respectively. The logMAR was significantly worse at 6 and 12 months postinfection in stage IIIb (p = 0.002 and p = 0.003, respectively; Wilcoxon signed-rank test) and at 6 months postinfection in stage IIIa (p = 0.036). The IOP was significantly elevated following infection in both stage IIIa and stage IIIb (p = 0.028 and p = 0.008 at 6 and 12 months, respectively, for stage IIIa; p = 0.002 and p = 0.005 for stage IIIb). The multiple logistic regression analysis revealed that being stage III and positive culture were significant risk factors for poor outcome for visual acuity (Odds ratio: 9.26 and 6.29, respectively) and that being stage III was a prognostic factor for increased IOP (Odds ratio: 8.33). Pseudophakia or aphakia was significantly associated with stage III and stage IIIb infections (Odds ratio: 2.85 and 6.30).
Stage III bleb-related infection causes significant visual loss and IOP elevation within 12 months after development. Therefore, preventative measures should be taken, especially in cases that are pseudophakic or aphakic.
确定在与滤过泡相关的感染发展后 12 个月时视力和眼内压(IOP)的变化。
作为日本青光眼学会滤过泡相关感染调查的一部分,对 146 例与滤过泡相关的感染患者的 146 只眼的数据进行了分析。采用多变量逻辑回归分析确定与视力预后不良、IOP 升高和 III 期相关的因素。
感染后 12 个月,I 期、II 期、IIIa 期和 IIIb 期感染的 logMAR 分别平均增加了 0.140、0.440、1.099 和 1.122。IIIb 期感染后 6 个月和 12 个月时的 logMAR 明显更差(p=0.002 和 p=0.003,Wilcoxon 符号秩检验),IIIa 期感染后 6 个月时的 logMAR 也明显更差(p=0.036)。IIIa 期和 IIIb 期感染后 IOP 均显著升高(IIIa 期在 6 个月和 12 个月时分别为 p=0.028 和 p=0.008,IIIb 期分别为 p=0.002 和 p=0.005)。多变量逻辑回归分析显示,III 期和阳性培养是视力预后不良的显著危险因素(优势比分别为 9.26 和 6.29),而 III 期是 IOP 升高的预后因素(优势比为 8.33)。白内障术后或无晶状体眼与 III 期和 IIIb 期感染显著相关(优势比分别为 2.85 和 6.30)。
III 期滤过泡相关感染在发病后 12 个月内可导致明显的视力丧失和 IOP 升高。因此,应采取预防措施,尤其是在白内障术后或无晶状体眼的情况下。