Department of Ophthalmology, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, ON, Canada.
Eur J Ophthalmol. 2021 Mar;31(2):607-611. doi: 10.1177/1120672120902032. Epub 2020 Jan 27.
The purpose was to evaluate the change in the microbiological profile of diabetic patients undergoing intravitreal injections for diabetic macular edema.
Patients were included in this prospective study when referred for the first time for intravitreal injection to treat diabetic macular edema. For each patient, conjunctival cultures were taken from the lower fornix of each eye prior to the povidone-iodine application and the intravitreal injection. An additional culture was taken from the treated eye 20 min after the injection. The same culture protocol was used for the two following injections of these patients. A later conjunctival culture was also taken a month after the last injection.
Twenty-one eyes of 21 patients were included. The mean duration of diabetes was 13.7 ± 7.9 years. Prior to the first intravitreal injection, 33% of cultures were positive. Prior to the third intravitreal injection, 26% of cultures were positive ( = 0.63), and 1 month after the last injection, 18% of cultures were positive ( = 0.495). The mean HbA1C was 8.1% ± 1.7%. HbA1C of patients with positive cultures was 8.0% ± 1.1% at the first intravitreal injection and 8.2% ± 1.0% at the third intravitreal injection. This was compared with HBA1C in eyes with negative cultures: 7.4% ± 1.2% ( = 0.45) and 7.1% ± 1.0% ( = 0.14), respectively.
Repeated intravitreal injection for diabetic macular edema with application of povidone-iodine 5% in diabetic patients did not lead to a significant change in the percentage of positive conjunctival cultures. Patients with higher HbA1C had a slight, non-statistically significant trend for positive cultures.
评估接受玻璃体内注射治疗糖尿病性黄斑水肿的糖尿病患者的微生物谱变化。
本前瞻性研究纳入首次因糖尿病性黄斑水肿接受玻璃体内注射治疗而转诊的患者。对于每例患者，在应用聚维酮碘前和玻璃体内注射时，从下穹隆取双眼结膜培养物。注射后 20 分钟，从治疗眼再次取培养物。对这些患者的随后两次注射，同样采用该培养方案。最后一次注射后 1 个月，还进行了后续结膜培养。
21 例患者的 21 只眼纳入研究。糖尿病的平均病程为 13.7±7.9 年。首次玻璃体内注射前，33%的培养物为阳性。第三次玻璃体内注射前，26%的培养物为阳性（=0.63），最后一次注射后 1 个月，18%的培养物为阳性（=0.495）。平均 HbA1C 为 8.1%±1.7%。培养物阳性患者的 HbA1C 在首次玻璃体内注射时为 8.0%±1.1%，在第三次玻璃体内注射时为 8.2%±1.0%。与之相比，培养物阴性患者的 HbA1C 分别为 7.4%±1.2%（=0.45）和 7.1%±1.0%（=0.14）。
在糖尿病患者中，应用 5%聚维酮碘重复进行玻璃体内注射治疗糖尿病性黄斑水肿，并未导致结膜培养阳性率显著变化。HbA1C 较高的患者，结膜培养阳性有轻度、但无统计学意义的趋势。
