Ratra Dhanashree, Saurabh Kumar, Das Debmalya, Nachiappan Kasinathan, Nagpal Amit, Rishi Ekta, Bhende Pramod, Sharma Tarun, Gopal Lingam
From the Bhagawan Mahavir Department of Vitreoretinal Diseases, Sankara Nethralaya Medical Research Foundation, Chennai, India.
Asia Pac J Ophthalmol (Phila). 2015 Sep-Oct;4(5):286-92. doi: 10.1097/APO.0000000000000120.
The aim of this study was to review the clinical profile including predisposing systemic conditions, microorganisms responsible, clinical presentation, and outcomes of endogenous endophthalmitis (EE) in South India.
This study is a retrospective, noncomparative case series.
This study presents a retrospective analysis of records of patients with EE in a 10-year period.
A total of 61 eyes of 58 patients were included in the study. Preceding systemic illness or surgery was noted in 31 patients (53.4%). No predisposing condition was found in 27 patients (46.5%). All eyes had severe diffuse EE. Culture positivity was seen in 34 of 58 patients (58.6%). Gram-positive organisms were isolated in 9 cases (15.5%), and Gram-negative organisms were isolated in 20 cases (34.5%). Pseudomonas aeruginosa (13.8%) was the most common isolate. Eleven eyes (18%) were managed medically with intravenous and intravitreal antibiotics, and 38 eyes (62.3%) also underwent vitrectomy. Eight eyes (13.1%) required repeat vitrectomy, and 12 eyes (19.7%) were eviscerated. The mean follow-up was 16.2 ± 13.9 months. Final visual acuity of 20/200 or better was seen in 29.5% eyes. A favorable outcome was noted in culture-positive patients (P = 0.03) and in patients with no predisposing causes.
This study provides information about the clinical and microbiologic profile of EE. Aggressive medical and surgical treatment can result in favorable outcomes.
本研究旨在回顾印度南部内源性眼内炎(EE)的临床特征,包括易感全身状况、致病微生物、临床表现及预后。
本研究为回顾性、非对照病例系列研究。
本研究对10年间EE患者的记录进行回顾性分析。
本研究共纳入58例患者的61只眼。31例患者(53.4%)有先前的全身疾病或手术史。27例患者(46.5%)未发现易感状况。所有患眼均为严重弥漫性EE。58例患者中有34例(58.6%)培养呈阳性。分离出革兰阳性菌9例(15.5%),革兰阴性菌20例(34.5%)。铜绿假单胞菌(13.8%)是最常见的分离菌。11只眼(18%)采用静脉及玻璃体内抗生素进行药物治疗,38只眼(62.3%)还接受了玻璃体切除术。8只眼(13.1%)需要重复玻璃体切除术,12只眼(19.7%)行眼球摘除术。平均随访时间为16.2±13.9个月。29.5%的患眼最终视力达到20/200或更好。培养阳性患者(P = 0.03)及无易感因素的患者预后良好。
本研究提供了有关EE临床及微生物学特征的信息。积极的药物及手术治疗可带来良好预后。