Sun Yu, Zeng Fanxing, Zhang Jingjing, Qi Xiaolin, Lu Xiuhai, Ning Na, Li Suxia, Zhang Ting, Yuan Gongqiang, Shi Weiyun, Gao Hua
Medical College of Qingdao University, Qingdao University, Qingdao, China.
Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
Mycopathologia. 2023 Oct;188(5):805-813. doi: 10.1007/s11046-023-00780-8. Epub 2023 Sep 22.
To investigate the differences in microbiological characteristics, risk factors, drug resistance, and visual outcomes in three infections: fungal keratitis with hypopyon (FKH), keratitis-related fungal endophthalmitis (FKE), and fungal endophthalmitis without keratitis (FE).
An analytical cross-sectional study.
In total, 14.57% of eyes with FKH progressed to endophthalmitis. Hypopyon, pre-existence of lens problems, topical steroid use and sever keratitis were significantly associated with the development of FKE. The risk factors of the FKH and FE group were mainly plant trauma and open globe trauma, respectively. Keratitis-related endophthalmitis (FKE) showed a significantly higher resistance than the other two groups. The FKH group had the best final visual acuity, while the FKE group had the worst.
Hypopyon height, pre-existing lens problems, topical steroid use and sever keratitis are risk factors for progression to endophthalmitis in eyes with fungal keratitis, and its progression is not affected by a single fungus. The antifungal drugs resistance in patients with endophthalmitis related to keratitis was significantly higher than that associated with other reasons. Timely diagnosis and risk factor assessment are essential for ensuring early treatment of FKE.
研究三种感染情况的微生物学特征、危险因素、耐药性及视力预后差异，这三种感染分别为伴有前房积脓的真菌性角膜炎（FKH）、与角膜炎相关的真菌性眼内炎（FKE）以及无角膜炎的真菌性眼内炎（FE）。
一项分析性横断面研究。
总体而言，14.57%的FKH患眼进展为眼内炎。前房积脓、晶状体问题的既往史、局部使用类固醇以及严重角膜炎与FKE的发生显著相关。FKH组和FE组的危险因素分别主要是植物性外伤和开放性眼球外伤。与角膜炎相关的眼内炎（FKE）显示出比其他两组显著更高的耐药性。FKH组最终视力最佳，而FKE组最差。
前房积脓高度、晶状体问题的既往史、局部使用类固醇以及严重角膜炎是真菌性角膜炎患眼进展为眼内炎的危险因素，且其进展不受单一真菌影响。与角膜炎相关的眼内炎患者的抗真菌药物耐药性显著高于其他原因所致者。及时诊断和危险因素评估对于确保FKE的早期治疗至关重要。
