Ding Jingwen, Zhang Yang, Feng Hui, Sun Hua
Department of Oculoplastic Surgery, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Eur J Ophthalmol. 2023 Nov;33(6):2194-2200. doi: 10.1177/11206721231163612. Epub 2023 Mar 16.
Ocular actinomycosis is an uncommon progressive infection. The study aims to investigate the predisposing factors, clinical characteristics and treatment outcomes of culture-proven cases of Actinomycotic primary canaliculitis.
Single-center, retrospective, interventional case series. Culture-proven cases of -associated primary canaliculitis diagnosed and treated between January 2017 and December 2021 at the Beijing Tongren Eye Center, Capital Medical University were identified and reviewed for ocular and systemic risk factors, clinical presentations, microbiological profile, treatment modalities and outcomes.
Of the 201 patients diagnosed with primary canaliculitis, 22 (10.9%) were caused by . The mean age at onset of 22 patients (21 women and one men) was 54 years. The lower canaliculus was most commonly involved (54.6%). The most frequent symptom was mattering without epiphora (77.3%) and clinical signs were punctal regurgitation of purulent discharge (100%) and expressible concretions (95.5%). Dry eye co-existed in 77.3% of patients, whereas no obvious systemic factors were found. Among 19 cases (86.0%) of identified species, (43.5%) was the predominant causative microorganism. There were 50% of patients with polymicrobial infection and the most common additional bacteria isolated were species. Conservative therapy combining repeated canalicular expression and irrigation with susceptible topical antibiotics achieved complete resolution in 86.4% of patients.
Dry eye was identified in the vast majority of patients with Actinomycotic canaliculitis. Most cases are odontogenic in origin and the infection occurs in immunocompetent individuals. The conservative method combining canalicular expression and irrigation with topical susceptible antibiotics is recommendable as initial therapy.
眼部放线菌病是一种罕见的进行性感染。本研究旨在探讨经培养证实的放线菌性原发性泪小管炎病例的易感因素、临床特征及治疗效果。
单中心、回顾性、干预性病例系列研究。对2017年1月至2021年12月在北京同仁眼科中心（首都医科大学）诊断并治疗的经培养证实的与[具体病因未给出]相关的原发性泪小管炎病例进行识别，并对眼部和全身危险因素、临床表现、微生物学特征、治疗方式及治疗效果进行回顾分析。
在201例诊断为原发性泪小管炎的患者中，22例（10.9%）由[具体病因未给出]引起。22例患者（21例女性和1例男性）的平均发病年龄为54岁。下泪小管受累最为常见（54.6%）。最常见的症状是有分泌物但无溢泪（77.3%），临床体征为脓性分泌物泪点反流（100%）和可挤出的结石（95.5%）。77.3%的患者同时存在干眼，而未发现明显的全身因素。在19例（86.0%）鉴定出[具体菌种未给出]菌种的病例中，[具体优势菌种未给出]（43.5%）是主要致病微生物。50%的患者存在混合微生物感染，最常见的其他分离细菌是[具体菌种未给出]菌种。联合反复泪小管挤压和冲洗以及敏感局部抗生素的保守治疗使86.4%的患者完全康复。
绝大多数放线菌性泪小管炎患者存在干眼。大多数病例起源于牙源性，感染发生在免疫功能正常的个体中。推荐联合泪小管挤压和冲洗以及局部敏感抗生素的保守方法作为初始治疗。
