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聚维酮碘灌注的玻璃体切除术治疗严重真菌性眼内炎。

Povidone iodine-infused pars plana vitrectomy for severe fungal endophthalmitis.

作者信息

Huang Denis, Tran Lillian, Li Jennifer Yh, Lee William, Kim Esther, Moussa Kareem

机构信息

Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, CA, USA.

出版信息

Am J Ophthalmol Case Rep. 2024 Oct 24;36:102207. doi: 10.1016/j.ajoc.2024.102207. eCollection 2024 Dec.

DOI:10.1016/j.ajoc.2024.102207
PMID:39553913
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11566710/
Abstract

PURPOSE

Arthrographis kalrae is an opportunistic fungus that can cause a severe and atypical endophthalmitis. In limited studies, low-dose povidone iodine has been shown to be effective in treating fulminant bacterial endophthalmitis. In this case report, we describe the successful treatment of recalcitrant keratitis-associated endophthalmitis with intraocular povidone iodine during pars plana vitrectomy.

OBSERVATIONS

A patient with keratitis-associated endophthalmitis had persistent disease despite aggressive medical management. The infection resolved following pars plana vitrectomy with infusion of dilute povidone iodine. No toxicity was noted postoperatively.

CONCLUSIONS AND IMPORTANCE

Povidone iodine-infused pars plana vitrectomy offers promise as a treatment for infectious endophthalmitis that fails medical management. This is the first report demonstrating eradication of fungal endophthalmitis using povidone iodine-infused pars plana vitrectomy.

摘要

目的

卡尔氏节菱孢是一种机会性真菌,可引起严重且非典型的眼内炎。在有限的研究中,低剂量聚维酮碘已被证明对治疗暴发性细菌性眼内炎有效。在本病例报告中,我们描述了在玻璃体切割术中使用眼内聚维酮碘成功治疗顽固性角膜炎相关性眼内炎的情况。

观察结果

一名患有角膜炎相关性眼内炎的患者尽管接受了积极的药物治疗,但疾病仍持续存在。在玻璃体切割术中注入稀释的聚维酮碘后,感染得到解决。术后未观察到毒性反应。

结论与意义

注入聚维酮碘的玻璃体切割术有望成为治疗药物治疗无效的感染性眼内炎的方法。这是第一份证明使用注入聚维酮碘的玻璃体切割术根除真菌性眼内炎的报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/bb8786eba672/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/9570340c3718/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/2708d6733a15/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/608166260845/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/4e04f8c985d7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/bb8786eba672/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/9570340c3718/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/2708d6733a15/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/608166260845/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/4e04f8c985d7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/510b/11566710/bb8786eba672/gr5.jpg

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本文引用的文献

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J Fungi (Basel). 2021 Nov 22;7(11):996. doi: 10.3390/jof7110996.
2
Intraocular Povidone Iodine During Pars Plana Vitrectomy for Severe and Atypical Endophthalmitis.严重非典型眼内炎行玻璃体切除术中应用聚维酮碘眼内冲洗。
Ophthalmic Surg Lasers Imaging Retina. 2021 Sep;52(9):485-490. doi: 10.3928/23258160-20210820-01. Epub 2021 Sep 1.
3
Povidone Iodine: Properties, Mechanisms of Action, and Role in Infection Control and Decolonization.聚维酮碘:性质、作用机制及在感染控制和去定植中的作用。
Antimicrob Agents Chemother. 2020 Aug 20;64(9). doi: 10.1128/AAC.00682-20.
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Arthrographis kalrae Keratitis Complicated by Endophthalmitis: A Case Report With Literature Review.卡尔拉氏枝孢霉性角膜炎合并眼内炎:病例报告并文献复习。
Eye Contact Lens. 2020 Nov;46(6):e59-e65. doi: 10.1097/ICL.0000000000000713.
5
Outcomes of therapeutic penetrating keratoplasty in 198 eyes with fungal keratitis.198 只真菌性角膜炎眼行治疗性穿透性角膜移植术的结果。
Indian J Ophthalmol. 2019 Oct;67(10):1599-1605. doi: 10.4103/ijo.IJO_1952_18.
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Intravitreal Injection of 1.25% Povidone Iodine Followed by Vitrectomy Using 0.025% Povidone Iodine Irrigation for Treating Endophthalmitis.玻璃体内注射1.25%聚维酮碘,随后使用0.025%聚维酮碘冲洗进行玻璃体切割术治疗眼内炎。
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Vitrectomy using 0.025% povidone-iodine in balanced salt solution plus for the treatment of postoperative endophthalmitis.使用含0.025%聚维酮碘的平衡盐溶液加液进行玻璃体切割术治疗术后眼内炎。
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Case Rep Infect Dis. 2013;2013:851875. doi: 10.1155/2013/851875. Epub 2013 Nov 27.
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