Wang Tiantian, Moinuddin Omar, Abuzaitoun Rebhi, Hwang Min, Besirli Cagri, Wubben Thomas J, Zacks David N
Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA.
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Clin Ophthalmol. 2021 Apr 13;15:1529-1537. doi: 10.2147/OPTH.S302757. eCollection 2021.
To analyze the risk factors, clinical course, and visual and anatomic outcomes of retinal detachment (RD) after endophthalmitis.
This retrospective study included 108 patients diagnosed with endophthalmitis between August 2014 and May 2019 at a single tertiary referral center. Sixteen patients developed RD after endophthalmitis. Retrospective analysis was performed to compare the cohort of endophthalmitis alone versus the cohort that developed RD after endophthalmitis, with analysis of potential risk factors for RD after endophthalmitis and treatment outcomes.
The incidence of RD after endophthalmitis was 14.8% (N=16/108). The median time to develop RD after endophthalmitis was 27 days (range: 1-581 days, IQR: 25.3). Thirteen (81.3%) cases of RD occurred less than 2 months after the diagnosis of endophthalmitis. The incidence of aphakia (p=0.023) and posterior synechia (PS) (p=0.014) were significantly higher in the RD group. The mean initial and final visual acuity (VA) of the endophthalmitis alone group was 1.9±0.8 logMAR and 1.2±1.0 logMAR (p<0.0001), respectively, and 1.9±0.9 logMAR and 1.3±1.2 logMAR (p=0.07) in the RD group, respectively. Enucleation or evisceration occurred in 31.3% of cases with RD after endophthalmitis. The rate of final retinal re-apposition for the RD cohort was 56.3%.
The anatomic and functional outcomes for RD after endophthalmitis remain poor, with significant risk for permanent vision loss. Aphakia and posterior synechiae were seen more often in cases with RD after endophthalmitis.
分析眼内炎后视网膜脱离(RD)的危险因素、临床病程以及视力和解剖学转归。
这项回顾性研究纳入了2014年8月至2019年5月在一家三级转诊中心诊断为眼内炎的108例患者。16例患者在眼内炎后发生了RD。进行回顾性分析以比较单纯眼内炎队列与眼内炎后发生RD的队列,分析眼内炎后RD的潜在危险因素及治疗转归。
眼内炎后RD的发生率为14.8%(N = 16/108)。眼内炎后发生RD的中位时间为27天(范围:1 - 581天,四分位间距:25.3)。13例(81.3%)RD病例发生在眼内炎诊断后2个月内。RD组无晶状体眼(p = 0.023)和虹膜后粘连(PS)(p = 0.014)的发生率显著更高。单纯眼内炎组的平均初始和最终视力(VA)分别为1.9±0.8 logMAR和1.2±1.0 logMAR(p<0.0001),RD组分别为1.9±0.9 logMAR和1.3±1.2 logMAR(p = 0.07)。眼内炎后发生RD的病例中,31.3%进行了眼球摘除或眼内容剜除术。RD队列的最终视网膜复位率为56.3%。
眼内炎后RD的解剖学和功能转归仍然较差,存在永久性视力丧失的重大风险。无晶状体眼和虹膜后粘连在眼内炎后发生RD的病例中更常见。