Hudson Julia L, Fan Jason C, Smiddy William E, Sridhar Jayanth, Yannuzzi Nicolas A, Flynn Harry W
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Retina. 2023 Apr 1;43(4):594-599. doi: 10.1097/IAE.0000000000003707.
The purpose of the study was to report the clinical features and best-corrected visual acuity outcomes in patients with acute- and delayed-onset endophthalmitis after open globe injuries.
The study included a retrospective, comparative, consecutive case series of patients with endophthalmitis after open globe injury between January 2016 and October 2020 at the Bascom Palmer Eye Institute.
Acute-onset endophthalmitis accounted for 16 of 20 cases (80%), and all cases were diagnosed at the initial examination. Delayed-onset endophthalmitis cases, occurring more than 2 weeks after injury, accounted for 4 of 20 cases (20%) and were because of Zone 1 wound leaks and infections. Factors associated with endophthalmitis included presence of a retained intraocular foreign body (11/20 [55%]) and delay of presentation >24 hours (15/20 [75%]) ( P < 0.001 and 0.002, respectively). The mean presenting best-corrected visual acuity was logMAR 1.64 (20/800), and the mean best-corrected visual acuity at the last follow-up was logMAR 1.22 (20/300).
In patients with open globe injury-related endophthalmitis, visual acuity outcomes are generally poor. Despite intravitreal antibiotics at primary closure, delayed-onset endophthalmitis cases may develop in the setting of compromised Zone 1 wound integrity.
本研究旨在报告开放性眼球损伤后急性和延迟性眼内炎患者的临床特征及最佳矫正视力结果。
本研究纳入了2016年1月至2020年10月在巴斯科姆·帕尔默眼科研究所就诊的开放性眼球损伤后眼内炎患者的回顾性、对照、连续病例系列。
急性眼内炎占20例中的16例（80%），所有病例均在初次检查时确诊。延迟性眼内炎病例发生在受伤2周后，占20例中的4例（20%），原因是1区伤口渗漏和感染。与眼内炎相关的因素包括眼内异物残留（11/20 [55%]）和就诊延迟>24小时（15/20 [75%]）（分别为P<0.001和0.002）。初诊时的平均最佳矫正视力为logMAR 1.64（20/800），最后一次随访时的平均最佳矫正视力为logMAR 1.22（20/300）。
在开放性眼球损伤相关性眼内炎患者中，视力结果通常较差。尽管在一期缝合时使用了玻璃体内抗生素，但在1区伤口完整性受损的情况下仍可能发生延迟性眼内炎。
