Fiore Tito, Lupidi Marco, Cerquaglia Alessio, Giansanti Fabrizio, Reibaldi Michele, Iaccheri Barbara, Tucci Davide, Messina Marco, Cagini Carlo
Department of Biomedical and Surgical Sciences, Section of Ophthalmology, 9309University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy.
Department of Translational Surgery and Medicine, Ophthalmology Unit, University of Firenze, Firenze, Italy.
Eur J Ophthalmol. 2022 Sep 28:11206721221129659. doi: 10.1177/11206721221129659.
Retrospective analysis of morphological and functional outcomes after pars-plana vitrectomy and Silicone-Oil (SO) endotamponade in acute postoperative endophthalmitis (APOE).
Minimum follow-up was 6 months. Every included patient received best-corrected visual acuity (BCVA) assessment, pre-operatively and at last follow-up. Spectralis OCT was used to investigate disorganization of inner (DRIL) and outer (DROL) retinal layers at 1, 3, 6 months and at last follow-up. OCT-A was performed to assess foveal avascular zone (FAZ) and vascular perfusion density (VPD) at 6 months and at last follow-up.
Seventeen eyes were recruited. Postoperative findings: BCVA ≥ 20/40 (in 14 eyes); epiretinal membranes (13); hyperreflective epiretinal material soon after surgery in (6) SO-filled eyes; inner retinal layers atrophy (5); macular edema (2); DROL (4) with persistent EZ disruption at final visit (2); no significant difference between study and fellow eyes in central macular thickness, FAZ and VPD; VPD decreased in all cases with prominent disorganization of retinal architecture.
OCT changes after APOE can be persistent or completely/partially self-resolving and seems related to the outward progression path of the infection/inflammation from the vitreous cavity to the inner and outer retina, rather than to the surgery.
对急性术后眼内炎（APOE）行玻璃体切割术联合硅油（SO）眼内填充术后的形态学和功能结果进行回顾性分析。
最小随访时间为6个月。每例纳入患者在术前及末次随访时均接受最佳矫正视力（BCVA）评估。使用Spectralis OCT在术后1、3、6个月及末次随访时研究视网膜内层（DRIL）和外层（DROL）的结构紊乱情况。在术后6个月及末次随访时进行光学相干断层扫描血管造影（OCT-A）以评估黄斑无血管区（FAZ）和血管灌注密度（VPD）。
共纳入17只眼。术后结果：BCVA≥20/40（14只眼）；视网膜前膜（13只眼）；6只硅油填充眼中术后早期出现高反射性视网膜前物质（6只眼）；视网膜内层萎缩（5只眼）；黄斑水肿（2只眼）；末次随访时4只眼出现DROL且2只眼的椭圆体带持续中断；研究眼与对侧眼在黄斑中心厚度、FAZ和VPD方面无显著差异；所有视网膜结构明显紊乱的病例中VPD均降低。
APOE后的OCT改变可能持续存在，或完全/部分自行消退，似乎与感染/炎症从玻璃体腔向视网膜内层和外层的向外进展路径有关，而非与手术相关。
