Neß Thomas
Klinik für Augenheilkunde, Medizinische Fakultät, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
Ophthalmologe. 2018 Aug;115(8):697-706. doi: 10.1007/s00347-018-0729-6.
Endophthalmitis is a severe intraocular infection with potentially devastating consequences, such as becoming blind or loss of an eyeball. It can be exogenous (postoperative or posttraumatic) or endogenous. The most frequent causes of postoperative endophthalmitis are cataract surgery and intravitreal injections. Typical symptoms are pain and loss of visual acuity. Hypopyon and infiltration of the vitreous body with the loss of the red reflex are the most important clinical findings for endophthalmitis. The diagnosis is primarily clinical and supported by microbiological cultures and PCR from the vitreous body and/or anterior chamber and is of use for a targeted treatment. Treatment is a combination of intravitreal, systemic, and topical antibiotics, anterior chamber lavage, and vitrectomy. The decisive factor for the prognosis is the triggering pathogen. Infections with coagulase-negative staphylococci or Candida spp. have a good prognosis. Infections with Streptococcus spp., Bacillus spp. or Aspergillus spp. are unfavorable.
眼内炎是一种严重的眼内感染,可能会导致毁灭性后果,如失明或眼球丧失。它可分为外源性(术后或创伤后)和内源性。术后眼内炎最常见的病因是白内障手术和玻璃体内注射。典型症状是疼痛和视力丧失。前房积脓和玻璃体浸润伴红光反射消失是眼内炎最重要的临床体征。诊断主要依靠临床症状,并通过玻璃体和/或前房的微生物培养及聚合酶链反应(PCR)来辅助,这有助于进行针对性治疗。治疗方法包括玻璃体内、全身和局部使用抗生素、前房灌洗和玻璃体切除术。预后的决定性因素是引发感染的病原体。凝固酶阴性葡萄球菌或念珠菌属感染的预后较好。链球菌属、芽孢杆菌属或曲霉菌属感染的预后则不佳。