Ozawa Kenji, Inuzuka Masayuki, Murata Kazuhiro, Ishihara Takuma, Mochizuki Kiyofumi, Sakaguchi Hirokazu
Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu, Gifu, 501-1194, Japan.
Ogaki Municipal Hospital, Ogaki, Japan.
Jpn J Ophthalmol. 2022 Nov;66(6):559-571. doi: 10.1007/s10384-022-00937-w. Epub 2022 Aug 17.
To identify the risk factors for a recurrence of a bleb-related infection (BRI).
Retrospective cohort study.
The medical records of all patients diagnosed with BRI at Gifu University Hospital between January 1989 and December 2020 were reviewed. The time when conjunctival hyperemia could not be detected and when the anterior chamber was quiet were defined as the resolution time of the BRI. The primary endpoint was a recurrence of a BRI. Kaplan-Meier estimation and the Cox proportional hazards model were used to determine the risk of a recurrence from the initial onset data of each eye. Bacteriological studies were performed to determine the pathogen causing the BRI.
There were 108 eyes of 103 patients followed for at least 3 months after the initial BRI. A recurrent bleb infection developed in 21 (19.4%) eyes of 21 patients (13 men, 8 women). Log-rank test at the 10-year follow-up examination revealed that hypotony at the onset of the BRI (P=0.004), the prophylactic use of topical antibiotics at the onset of the BRI (P=0.046), and bleb leakage after the resolution of the BRI (P=0.021) were significantly associated with a BRI recurrence. Cox proportional hazards model showed that ocular hypotony at the onset of the BRI (unadjusted, P=0.007; adjusted for bleb leakage, P=0.015) and bleb leakage after the resolution of the BRI (unadjusted, P=0.027; adjusted for hypotony, P=0.024) were significantly associated with a BRI recurrence. Other factors were not significantly associated with the recurrence of a BRI.
We recommend close observations when a bleb leakage is detected after the BRI has resolved.
确定与滤泡相关感染（BRI）复发的危险因素。
回顾性队列研究。
回顾了1989年1月至2020年12月期间在岐阜大学医院被诊断为BRI的所有患者的病历。结膜充血无法检测到且前房安静的时间被定义为BRI的消退时间。主要终点是BRI的复发。使用Kaplan-Meier估计法和Cox比例风险模型从每只眼睛的初始发病数据确定复发风险。进行细菌学研究以确定导致BRI的病原体。
103例患者的108只眼睛在初次BRI后至少随访了3个月。21例患者（13名男性，8名女性）的21只眼睛（19.4%）发生了滤泡感染复发。在10年随访检查中的对数秩检验显示，BRI发病时的低眼压（P=0.004）、BRI发病时局部抗生素的预防性使用（P=0.046）以及BRI消退后的滤泡渗漏（P=0.021）与BRI复发显著相关。Cox比例风险模型显示，BRI发病时的眼压过低（未调整; P=0.007; 经滤泡渗漏调整后，P=0.015）和BRI消退后的滤泡渗漏（未调整; P=0.027; 经眼压过低调整后，P=0.024）与BRI复发显著相关。其他因素与BRI复发无显著相关性。
我们建议在BRI消退后检测到滤泡渗漏时进行密切观察。
