Department of Ophthalmology, Shengjing Hospital of China Medical University, Heping district, Sanhao Road 36, Shenyang, 110004, People's Republic of China.
BMC Infect Dis. 2020 Sep 7;20(1):661. doi: 10.1186/s12879-020-05390-z.
Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess.
Between April 2014 and April 2019, the clinical data of 16 patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we evaluated the final visual outcomes in the patients to determine the efficacy of surgery.
Fifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) only underwent intravitreal injection. Of the 16 patients, 3 patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5%) had visual acuity restored to 20/200, 6 eyes (31%) had visual acuity restored to counting fingers (CF), 2 eyes (11%) had visual acuity restored to hand motion (HM), 4 eyes (22%) showed only light perception (LP), and the remaining 6 eyes (31%) showed no light perception (NLP). Drug susceptibility tests suggested that the carbapenems exhibited significant effects in the inflammatory reaction.
Endogenous endophthalmitis caused by liver abscess is a very serious condition, and the final visual outcome is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest.
内源性眼内炎是由眼内感染引起的严重疾病，可迅速进展导致失明。本研究评估了肝脓肿引起的眼内炎患者的临床特征、手术和抗生素治疗策略以及治疗结果。
回顾性分析 2014 年 4 月至 2019 年 4 月在盛京医院接受手术治疗的 16 例（19 只眼）肝脓肿相关性眼内炎患者的临床资料。此外，我们评估了患者的最终视力结果，以确定手术的疗效。
15 例（18 只眼）患者入院后行玻璃体腔内注射联合玻璃体切除术，1 例（1 只眼）仅行玻璃体腔内注射。16 例患者中，3 例（3 只眼）眼内炎症复发，最终行眼内容剜除术。所有患者均根据玻璃体培养、血培养和药敏试验结果给予全身抗生素治疗。门诊随访至患者病情稳定（6 个月）。19 只眼中，1 只眼（5%）视力恢复至 20/200，6 只眼（31%）视力恢复至指数（CF），2 只眼（11%）视力恢复至手动（HM），4 只眼（22%）仅光感（LP），其余 6 只眼（31%）无光感（NLP）。药敏试验提示碳青霉烯类药物对炎症反应有显著疗效。
肝脓肿引起的内源性眼内炎病情严重，最终视力预后较差。及时的手术干预联合抗生素治疗至关重要，必须治疗原发性疾病，以尽早控制疾病进展。
