Labardini Cecilia P, Blumenthal Eytan Z
Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.
The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Rambam Maimonides Med J. 2018 Sep 2;9(4):1-6. doi: 10.5041/RMMJ.10348.
Intravitreal injection of anti-vascular endothelial growth factor is currently the preferred treatment for several posterior segment diseases, including age-related macular degeneration and diabetic retinopathy, as well as macular edema and retinal vein occlusion. As an invasive procedure it involves risks. The most significant risk is infectious endophthalmitis, a sight-threatening and even a globe-threatening acute fulminant condition. Most common pathogens include Streptococcus and Staphylococcus species, surprisingly originating from the patient's, surgeon's, or nurse's mouth. Infectious endophthalmitis may have devastating and irreversible effect, with Streptococcus-induced cases having the worst visual outcome. It is therefore crucial for clinicians to promptly recognize and treat such conditions, and, far more important, to put in place protective and preventive measures against this rare, but sight-threatening complication. To that end, this paper describes the most common pathogens causing endophthalmitis after IVI of anti-VEGF, and defines their source, to aid the physician in developing strategies to prevent this catastrophic infection.
玻璃体内注射抗血管内皮生长因子目前是治疗几种后段疾病的首选方法，这些疾病包括年龄相关性黄斑变性、糖尿病性视网膜病变，以及黄斑水肿和视网膜静脉阻塞。作为一种侵入性操作，它存在风险。最严重的风险是感染性眼内炎，这是一种威胁视力甚至威胁眼球的急性暴发性疾病。最常见的病原体包括链球菌和葡萄球菌，令人惊讶的是，它们源自患者、外科医生或护士的口腔。感染性眼内炎可能产生毁灭性和不可逆转的影响，其中由链球菌引起的病例视力预后最差。因此，临床医生及时识别和治疗此类病症至关重要，而更重要的是，要针对这种罕见但威胁视力的并发症采取保护和预防措施。为此，本文描述了抗VEGF玻璃体内注射后引起眼内炎的最常见病原体，并确定其来源，以帮助医生制定预防这种灾难性感染的策略。
