Bhurayanontachai Patama, Klongthanakit Phingphan
Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, 15 Karnjanawanich Road, Hat Yai, Songkhla 90110, Thailand.
J Ophthalmol. 2020 Dec 15;2020:6689081. doi: 10.1155/2020/6689081. eCollection 2020.
To investigate patient characteristics, clinical features, common causative organisms, and visual acuity outcomes in endogenous endophthalmitis.
This was a retrospective chart analysis of patients with endogenous endophthalmitis between January 2006 and December 2019. Collected data included basic patient characteristics, presenting symptoms, causative organisms, treatments, and 3-month and 1-year visual outcomes.
Twenty-nine eyes of 27 patients were included in the study. The mean age of the patients was 45.4 ± 19.9 years, and 63% were female. Visual acuity at presentation ranged from counting fingers to no light perception. Systemic comorbidities presented in 66.7% of the patients, the majority of which were related to diabetes mellitus (48.1%). The most common primary infection was a urinary tract infection. Positive blood cultures were identified in 48.1% of patients, and positive cultures from vitreous and aqueous samples were identified in 59.3% and 31.6% of eyes, respectively. Among all the specimens, Gram-positive bacteria were identified in 55.5%, Gram-negative bacteria in 22.2%, fungi in 14.8%, and mixed organisms in 7.4%. Among ocular specimens, 61.1% contained Gram-positive organisms, 16.7% contained Gram-negative organisms, and 22.2% contained fungi. was the most common causative organism. From 29 eyes, 18 (62.1%) underwent vitrectomy, and 12 (42.9%) underwent either evisceration or enucleation. Positive vitreous culture was significantly associated with unfavorable final visual outcome. Final visual acuity ranged from 20/125 to no light perception. Although visual improvement at 3 months was significantly better in younger patients, this had no impact on final visual outcome at 1 year.
Eyes with positive vitreous cultures had significantly poorer visual outcomes. Despite full treatment coverage, visual prognosis was extremely poor and the rates of blindness and evisceration/enucleation were still high.
研究内源性眼内炎患者的特征、临床特点、常见致病微生物及视力预后。
这是一项对2006年1月至2019年12月期间内源性眼内炎患者的回顾性病历分析。收集的数据包括患者基本特征、就诊症状、致病微生物、治疗方法以及3个月和1年的视力预后。
本研究纳入了27例患者的29只眼。患者的平均年龄为45.4±19.9岁，63%为女性。就诊时的视力范围从数指到无光感。66.7%的患者存在全身合并症，其中大多数与糖尿病有关（48.1%）。最常见的原发性感染是尿路感染。48.1%的患者血培养呈阳性，玻璃体和房水样本培养阳性的眼部分别为59.3%和31.6%。在所有标本中，革兰氏阳性菌占55.5%，革兰氏阴性菌占22.2%，真菌占14.8%，混合菌占7.4%。在眼内标本中，61.1%含有革兰氏阳性菌，16.7%含有革兰氏阴性菌，22.2%含有真菌。 是最常见的致病微生物。29只眼中，18只（62.1%）接受了玻璃体切除术，12只（42.9%）接受了眼球内容剜除术或眼球摘除术。玻璃体培养阳性与不良的最终视力预后显著相关。最终视力范围从20/125到无光感。虽然年轻患者在3个月时视力改善明显更好，但这对1年时的最终视力预后没有影响。
玻璃体培养阳性的眼视力预后明显较差。尽管进行了全面治疗，但视力预后极差，失明率和眼球内容剜除术/眼球摘除术的发生率仍然很高。
