Fabiani Claudia, Agarwal Manisha, Dogra Mohit, Tosi Gian Marco, Davis Janet L
Department of Medical Sciences, Surgery and Neurosciences, Unit of Ophthalmology, University of Siena, Siena, Italy.
Department of Vitreoretina and Uvea, Dr Shroff's Charity Eye Hospital New Delhi, Daryaganj, India.
Ocul Immunol Inflamm. 2023 Sep;31(7):1386-1395. doi: 10.1080/09273948.2022.2152699. Epub 2022 Dec 19.
Exogenous endophthalmitis (ExE) results from microbial infection as a complication of ocular surgery, penetrating ocular trauma, and intraocular foreign bodies. We herein review the classification of ExE, etiological agents, differential diagnosis and therapeutic challenges.
Narrative Literature Review.
Identification of the causative agent through ocular fluid analysis is central in the diagnostic work-up of ExE. Prompt intravitreal antimicrobial therapy is key to successful management of ExE and vitrectomy is essential in severe cases. In culture-negative cases, and in the presence of specific features, a diagnosis of sterile intraocular inflammation or toxic syndrome should be suspected.
Strict adherence to treatment guidelines may improve outcomes of ExE, however the ultimate prognosis, especially in severe cases, may depend more on the virulence of the causative organism and associated ocular complications. Accurate differential diagnosis and effective treatment are crucial elements in the management and prognosis of non-infectious masquerades of ExE.
外源性眼内炎（ExE）是由微生物感染引起的，是眼科手术、眼球穿通伤和眼内异物的并发症。我们在此综述外源性眼内炎的分类、病原体、鉴别诊断和治疗挑战。
叙述性文献综述。
通过眼内液分析确定病原体是外源性眼内炎诊断检查的核心。及时进行玻璃体腔内抗微生物治疗是外源性眼内炎成功治疗的关键，在严重病例中玻璃体切除术必不可少。在培养阴性的病例中，以及存在特定特征时，应怀疑无菌性眼内炎症或毒性综合征的诊断。
严格遵守治疗指南可能会改善外源性眼内炎的治疗结果，然而最终预后，尤其是在严重病例中，可能更多地取决于病原体的毒力和相关的眼部并发症。准确的鉴别诊断和有效的治疗是外源性眼内炎非感染性伪装管理和预后的关键因素。
