Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan.
University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan.
Retina. 2024 May 1;44(5):916-922. doi: 10.1097/IAE.0000000000004043.
To determine whether universal masking during COVID-19 altered rate and outcomes of postinjection endophthalmitis.
Retrospective, single-site, comparative, cohort study. Eyes diagnosed with endophthalmitis within 4 weeks of intravitreal injection at the University of Michigan from August 1, 2012, to November 15, 2022, were identified. Cases were considered "masking" between March 15, 2020, and November 15, 2022. Endophthalmitis rate, visual acuity, and microbial spectrum were investigated.
There were 20 postinjection endophthalmitis cases out of 72,194 injections (0.028%; one in 3,571 injections) premasking and 10 of 38,962 with universal masking (0.026%; one in 3,846 injections; odds ratio 0.9; 95% [confidence interval]: 0.4-2.0). Referral from the community was unchanged with 32 cases referred premasking (0.35 cases/month) and 10 cases with masking (0.31 cases/month). Presenting mean the logarithm of the minimum angle of resolution visual acuity with masking of all postinjection endophthalmitis cases trended worse (2.35 ± 0.40) compared with premasking (2.09 ± 0.48; P = 0.05) with light perception visual acuity more common with masking (31.6% vs. 10.9%, P = 0.06). There was no delay in time from procedure to initial treatment ( P = 0.36), no difference in the rate of initial treatment with tap and inject (T/I), and similar positive-culture rates ( P = 0.77) between the cohorts. Visual acuity after 30 days of follow-up was clinically unchanged (∼20/500 vs. 20/400; P = 0.59).
Universal masking had no effect on postinjection endophthalmitis rate or on the rate of culture-positive cases. Although presenting visual acuity appeared worse with masking, this was not statistically significant, and current treatment paradigms resulted in similar visual outcomes.
确定 COVID-19 期间普遍戴口罩是否改变了眼内注射后眼内炎的发生率和结局。
回顾性、单中心、对照、队列研究。2012 年 8 月 1 日至 2022 年 11 月 15 日期间，在密歇根大学接受玻璃体腔内注射后 4 周内被诊断为眼内炎的眼被确定为病例。2020 年 3 月 15 日至 2022 年 11 月 15 日期间被认为是“戴口罩”。调查眼内炎发生率、视力和微生物谱。
在 72194 次注射中，有 20 例眼内炎（0.028%；每 3571 次注射 1 例）发生在戴口罩之前，38962 次注射中有 10 例（0.026%；每 3846 次注射 1 例；优势比 0.9；95%[置信区间]：0.4-2.0）。社区转诊未发生变化，戴口罩前有 32 例（0.35 例/月），戴口罩后有 10 例（0.31 例/月）。所有眼内炎病例的视力记录值的中位数（均数±标准差）在戴口罩时为 2.35±0.40，略差于不戴口罩时的 2.09±0.48（P=0.05），且戴口罩时视力更常见于光感（31.6%比 10.9%，P=0.06）。从手术到初次治疗的时间无延迟（P=0.36），初次治疗中 T/I 比例也无差异（P=0.77），两组的阳性培养率也无差异（P=0.77）。30 天随访后的视力无明显变化（~20/500 比 20/400；P=0.59）。
普遍戴口罩对眼内注射后眼内炎的发生率或培养阳性病例的发生率均无影响。虽然戴口罩时的视力表现更差，但无统计学意义，目前的治疗方案仍可获得相似的视力结果。
