Li Xiaoxia, Chen Zhi, Zhang Xiuwen, Zhou Zimei, Boost Maureen, Huang Taomin, Zhou Xingtao
Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.
Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.
Antibiotics (Basel). 2024 Feb 20;13(3):199. doi: 10.3390/antibiotics13030199.
The aims of this study are to investigate the etiology, microbiological spectrum, and risk factors associated with visual outcomes of fungal endophthalmitis (FE) in a tertiary eye specialty hospital in Shanghai, China.
This was a retrospective, single-center case series. The clinical characteristics, etiology, microbiological spectrum, and management, as well as the visual outcomes, were analyzed. Logistic regression was used to analyze the factors related to visual outcomes.
This study involved 102 eyes of 92 patients with FE, including 63 males (66.3%). The mean age was 44.4 ± 19.8 years. The most common etiology of FE was trauma (56.5%). The predominant fungal species isolated were spp. (31/93, 33.3%). Pars plana vitrectomy (PPV) and intravitreal antifungal agents was performed initially in 86 (84.3%) and 83 (81.4%) eyes, respectively. Only 35 (34.3%) eyes achieved final best corrected visual acuity (BCVA) of 20/400 or better. Ten (9.8%) eyes had a final BCVA of light perception or worse, and five (4.9%) had to be enucleated. The factors determining better visual outcomes included initial visual acuity better than finger-counting (FC) (odds ratio (OR) 5.811, = 0.036), the absence of corneal infiltrate (OR 10.131, = 0.002), and Candida species infection (OR 6.325, = 0.011).
Early diagnosis of FE and a timely vitrectomy, combined with an intravitreal injection of an antifungal drug, can mitigate the devastating results of intraocular fungal infection. Not being infected by spp., an initial BCVA that was no worse than FC, and the absence of corneal involvement were related to better visual prognosis.
本研究旨在调查中国上海一家三级眼科专科医院真菌性眼内炎（FE）的病因、微生物谱以及与视觉预后相关的危险因素。
这是一项回顾性单中心病例系列研究。分析了临床特征、病因、微生物谱、治疗方法以及视觉预后。采用逻辑回归分析与视觉预后相关的因素。
本研究纳入了92例FE患者的102只眼，其中男性63例（66.3%）。平均年龄为44.4±19.8岁。FE最常见的病因是外伤（56.5%）。分离出的主要真菌种类为 菌属（31/93，33.3%）。分别有86只眼（84.3%）和83只眼（81.4%）最初接受了玻璃体切割术（PPV）和玻璃体内抗真菌药物注射。仅有35只眼（34.3%）最终最佳矫正视力（BCVA）达到20/400或更好。10只眼（9.8%）最终BCVA为光感或更差，5只眼（4.9%）不得不摘除眼球。决定更好视觉预后的因素包括初始视力优于数指（FC）（比值比（OR）5.811， = 0.036）、无角膜浸润（OR 10.131， = 0.002）以及念珠菌属感染（OR 6.325， = 0.011）。
FE的早期诊断以及及时的玻璃体切割术，联合玻璃体内注射抗真菌药物，可减轻眼内真菌感染的严重后果。未被 菌属感染、初始BCVA不差于FC以及无角膜受累与更好的视觉预后相关。
