Ophthalmologic Center of the Second Hospital, Jilin University, Ziqiang Street 218, Changchun, 130000, People's Republic of China.
Int Ophthalmol. 2024 Jul 8;44(1):321. doi: 10.1007/s10792-024-03208-4.
To investigate whether the clinical characteristics, treatment and prognosis of endogenous infectious endophthalmitis (EIE) have changed over the past 5 years.
Retrospectively analyze all articles about EIE published in the PubMed, Web of Science, and Embase databases from 2017 to 2021.
A total of 128 patients and 147 eyes (46 left and 60 right) were included in the study. The mean age at diagnosis was 51 ± 19 years. The most common risk factors were diabetes and intravenous drug use. From 2017 to 2021, Klebsiella was the most common pathogenic microorganism (22%), and vitreous culture had the highest positivity rate. The most common complaint was blurred vision. The mean visual acuity (logMAR) at onset was 2.84, and the clinical symptoms were vitreal inflammation and opacity (63%), ocular pain (37%), and conjunctival congestion (36%). The ocular inflammation could be reduced by intraocular antibiotics or vitrectomy. However, the visual prognosis, with a mean logMAR of 2.73; only 50% of the eyes reached a visual acuity level of finger count and above. Changes in diagnostics over the past 5 years have mainly manifested as more diverse microorganism culture methods. In addition to conventional culture methods, PCR, sputum culture and aqueous humour culture are also commonly used for the diagnosis of pathogenic bacteria, improving the positive culture rate and visual prognosis.
The prognosis of EIE is poor. It is recommended to pay attention to the pathogenic bacteria culture results and accompanying systemic diseases and to diagnose and treat patients as soon as possible.
探讨近 5 年内生性眼内感染（endogenous infectious endophthalmitis，EIE）的临床特征、治疗及预后是否发生变化。
回顾性分析 2017 年至 2021 年在 PubMed、Web of Science 和 Embase 数据库中发表的所有关于 EIE 的文章。
共纳入 128 例（147 只眼，46 只左眼，60 只右眼）患者。诊断时的平均年龄为 51±19 岁。最常见的危险因素是糖尿病和静脉吸毒。2017 年至 2021 年，最常见的病原体是肺炎克雷伯菌（22%），玻璃体培养阳性率最高。最常见的主诉是视力模糊。发病时平均视力（logMAR）为 2.84，临床症状为玻璃体炎症和混浊（63%）、眼部疼痛（37%）和结膜充血（36%）。眼内抗生素或玻璃体切除术可减轻眼内炎症，但视力预后较差，logMAR 平均值为 2.73；只有 50%的眼视力达到手动计数及以上。近 5 年来诊断方法的变化主要表现为微生物培养方法的多样化。除了传统的培养方法外，聚合酶链反应（PCR）、痰培养和房水培养也常用于细菌病原学诊断，提高了阳性培养率和视力预后。
EIE 的预后较差。建议关注病原菌培养结果和伴随的全身疾病，并尽快对患者进行诊断和治疗。
