Gibbons Alison B, Elsafy Ramy, Campbell Ashley, Li Emily
School of Medicine, The Johns Hopkins University, Baltimore, Maryland, USA.
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
Orbit. 2025 Apr;44(2):163-170. doi: 10.1080/01676830.2024.2397027. Epub 2024 Sep 17.
To characterize trends in orbital cellulitis (OC) severity and management from 2016 through 2022, including assessment of effects from the COVID-19 pandemic.
A retrospective chart review was conducted at a tertiary care center using an electronic medical record search of OC from January 1 2016 to January 1 2023. Radiography was used to categorize patients into three cohorts - OC without abscess, OC with subperiosteal abscess (SPA), and OC with orbital abscess (OA). Infection cohort and age group [pediatric (<9 years old), adolescent (9-18 years), adult (>18 years)] were compared across years. Subgroup analysis was performed in the SPA cohort. Comparisons were made between the time periods prior to and after the start of the COVID-19 pandemic.
From 2016-2022, there were 247 (67.3%) cases of OC, 103 (28.1%) SPA, and 17 (4.6%) OA. The year 2022 incurred higher rates of SPA and OA ( = 0.035), pediatric infections ( = 0.008), and co-morbid sinusitis ( = 0.005) compared to all preceding years. Rates were similar from 2016 through 2021. Within the SPA cohort, rates of surgical intervention and outcomes were similar across all years. Rate of abscess formation was significantly higher during the COVID-19 pandemic compared to the pre-pandemic era ( = 0.033).
The severity of OC leading up to the COVID-19 pandemic appeared steady. After pandemic onset, a delayed increase in abscess formation, predominantly affecting pediatric patients and correlating with a greater rate of sinusitis, was observed in 2022.
描述2016年至2022年眼眶蜂窝织炎（OC）的严重程度和治疗趋势，包括评估新冠疫情的影响。
在一家三级医疗中心进行回顾性病历审查，利用电子病历搜索2016年1月1日至2023年1月1日期间的OC病例。通过影像学检查将患者分为三个队列——无脓肿的OC、伴有骨膜下脓肿（SPA）的OC和伴有眼眶脓肿（OA）的OC。比较各年份的感染队列和年龄组[儿科（<9岁）、青少年（9 - 18岁）、成人（>18岁）]。对SPA队列进行亚组分析。比较新冠疫情开始前后的时间段。
2016 - 2022年，有247例（67.3%）OC病例，103例（28.1%）SPA病例，17例（4.6%）OA病例。与之前所有年份相比，2022年SPA和OA的发生率更高（P = 0.035），儿科感染发生率更高（P = 0.008），合并鼻窦炎发生率更高（P = 0.005）。2016年至2021年的发生率相似。在SPA队列中，各年份的手术干预率和结果相似。与疫情前时代相比，新冠疫情期间脓肿形成率显著更高（P = 0.033）。
在新冠疫情之前，OC的严重程度似乎保持稳定。疫情开始后，2022年观察到脓肿形成有所延迟增加，主要影响儿科患者，且与更高的鼻窦炎发生率相关。
