Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Ocul Immunol Inflamm. 2024 Aug;32(6):818-826. doi: 10.1080/09273948.2023.2221341. Epub 2023 Jun 22.
This study assessed prognostic factors and the role of vitrectomy in patients with subretinal abscesses secondary to endophthalmitis. We reviewed published studies, including three cases from our cohort. Among 50 eyes, 26 had poor visual outcomes (final visual acuity <20/800, eyeball removal, or phthisis bulbi). Poor outcomes correlated with delayed ocular symptom-to-diagnosis time, initial visual acuity <20/800, severe vitritis, and macular involvement of abscesses ( < 0.001, = 0.008, < 0.001, and = 0.033, respectively). Vitrectomy had a trend towards reducing eyeball removal and phthisis bulbi rates compared with non-vitrectomy (10.8% vs 30.8%, = 0.181). However, the final visual acuity was not different and the rate of retinal detachment tended to be higher in vitrectomized eyes (45.9% vs 15.4%, = 0.095). The study suggested that vitrectomy and drainage of subretinal abscesses could be avoided in patients with a mild degree of vitritis.
本研究评估了眼内炎引起的视网膜下脓肿患者的预后因素和玻璃体切除术的作用。我们回顾了已发表的研究,包括我们队列中的三例病例。在 50 只眼中,26 只眼视力预后不良(最终视力<20/800、眼球摘除或眼球萎缩)。不良预后与眼部症状到诊断的时间延迟、初始视力<20/800、严重的玻璃体炎症和脓肿的黄斑受累有关(<0.001、=0.008、<0.001 和=0.033)。与非玻璃体切除术相比,玻璃体切除术有降低眼球摘除和眼球萎缩发生率的趋势(10.8% vs 30.8%,=0.181)。然而,最终视力没有差异,玻璃体切除眼中视网膜脱离的发生率较高(45.9% vs 15.4%,=0.095)。该研究表明,对于轻度玻璃体炎症的患者,可以避免进行玻璃体切除术和视网膜下脓肿引流。