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玻璃体平坦部玻璃体切除术在真菌性内源性眼内炎治疗中的作用。

The role of pars plana vitrectomy in the management of fungal endogenous endophthalmitis.

作者信息

Celiker Hande, Kazokoglu Haluk

机构信息

Department of Ophthalmology, School of Medicine, Marmara University, Istanbul, Turkey.

出版信息

Eur J Ophthalmol. 2020 Jan;30(1):88-93. doi: 10.1177/1120672118815105. Epub 2018 Nov 26.

Abstract

PURPOSE

To identify the causative microorganism of fungal endogenous endophthalmitis in our tertiary referral uveitis center and review the therapeutic role of pars plana vitrectomy in patients with fungal endogenous endophthalmitis.

METHODS

Seven eyes of six cases were identified as fungal endogenous endophthalmitis through positive cultures of ocular fluids and clinical presentations. The final anatomical and functional results were evaluated.

RESULTS

Four women (66.7%) and two men (33.3%) underwent vitrectomy. Control of infection was achieved early on in all cases. (71.4%) and (28.6%) species were identified as causative fungi in patients with fungal endogenous endophthalmitis. Two patients were reoperated due to reinfection and retinal detachment, respectively. Visual acuity improved in six eyes (85.7%) and worsened in one eye (14.3%). At the final examination, the retina was flat in all cases. No eye developed phthisis bulbi.

CONCLUSION

species are the most common causative organisms of fungal endogenous endophthalmitis in this study. Pars plana vitrectomy in fungal endogenous endophthalmitis may enhance the treatment of infection by removing fungal elements in the vitreous and aid in diagnosis. Vitrectomy may also be an important tool in the management of vision-threatening post-infectious sequelae such as retinal detachment and reinfections.

摘要

目的

在我们的三级转诊葡萄膜炎中心确定真菌性内源性眼内炎的致病微生物,并回顾玻璃体切割术在真菌性内源性眼内炎患者中的治疗作用。

方法

通过眼内液培养阳性及临床表现,6例患者的7只眼被确诊为真菌性内源性眼内炎。评估最终的解剖和功能结果。

结果

4名女性(66.7%)和2名男性(33.3%)接受了玻璃体切割术。所有病例早期均实现了感染控制。在真菌性内源性眼内炎患者中,(71.4%)和(28.6%)的菌种被确定为致病真菌。2例患者分别因再次感染和视网膜脱离接受了二次手术。6只眼(85.7%)视力提高,1只眼(14.3%)视力下降。在最后一次检查时,所有病例视网膜均平伏。无眼发生眼球痨。

结论

在本研究中,菌种是真菌性内源性眼内炎最常见的致病生物。玻璃体切割术治疗真菌性内源性眼内炎可通过清除玻璃体中的真菌成分增强感染治疗效果并有助于诊断。玻璃体切割术也可能是处理如视网膜脱离和再次感染等威胁视力的感染后后遗症的重要工具。

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