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内源性眼内炎患者的临床表现及预后

Clinical presentation and outcome of patients with endogenous endophthalmitis.

作者信息

Hayat Serife Ciloglu, Yilmaz Yusuf Cem, Ermis Serhat, Ozal Ece, Karapapak Murat, Baybora Hakan, Ozal Sadık Altan

机构信息

Department of Ophthalmology, Basaksehir Cam and Sakura City Hospital, Başakşehir Olympic Boulevard Road, 34480, Başakşehir, Istanbul, Turkey.

出版信息

Int Ophthalmol. 2025 Jan 22;45(1):31. doi: 10.1007/s10792-024-03342-z.

Abstract

PURPOSE

The study aims to evaluate the clinical characteristics, risk factors, microbiological findings, and visual outcomes, as well as patient and eye survival, of patients diagnosed with endogenous endophthalmitis (EE).

METHODS

A retrospective study was conducted on 29 eyes from 21 patients diagnosed with EE.

RESULTS

The mean age of presentation was 56.8 years, with a male predominance. The most common predisposing factors were diabetes mellitus and recurrent urinary tract infections. 42.9% of patients exhibited positive blood cultures, whereas positive vitreous cultures were detected in 38.1% of patients. The majority of cases were caused by bacterial infections. The median final visual acuity was 2 (0.1-2.9) LogMAR, with no significant difference between the bacterial and fungal groups. According to the Kaplan-Meier analysis, first-year survival rate was 90.5%, and the rate of eye preservation (at least one eye) was significantly lower in the presence of immunosuppresant drug usage (p = 0.004, Log Rank = 8.348).

CONCLUSION

Endogenous endophthalmitis typically has a poor visual prognosis, with the loss of anatomical integrity or mortality not being uncommon. The findings of the study provide insights into the clinical and microbiological characteristics of patients with EE in Turkey. Initial visual acuity and severe intraocular inflammation at presentation have been identified as predictors of poor visual outcomes. The negative impact of immunosuppressive drug use on globe survival has been noted. In patients using immunosuppressive drugs, healthcare providers being vigilant towards infectious pathologies and prompt intervention may increase the chances of success in EE treatment.

摘要

目的

本研究旨在评估诊断为内源性眼内炎(EE)患者的临床特征、危险因素、微生物学检查结果、视力预后,以及患者和眼球的存活率。

方法

对21例诊断为EE的患者的29只眼进行回顾性研究。

结果

就诊时的平均年龄为56.8岁,男性居多。最常见的易感因素是糖尿病和复发性尿路感染。42.9%的患者血培养呈阳性,而38.1%的患者玻璃体培养呈阳性。大多数病例由细菌感染引起。最终视力中位数为2(0.1 - 2.9)LogMAR,细菌组和真菌组之间无显著差异。根据Kaplan - Meier分析,第一年存活率为90.5%,使用免疫抑制药物时眼球保留率(至少一只眼)显著降低(p = 0.004,对数秩 = 8.348)。

结论

内源性眼内炎通常视力预后较差,解剖结构完整性丧失或死亡并不罕见。本研究结果为土耳其EE患者的临床和微生物学特征提供了见解。就诊时的初始视力和严重的眼内炎症已被确定为视力预后不良的预测因素。已注意到免疫抑制药物使用对眼球存活的负面影响。对于使用免疫抑制药物的患者,医疗服务提供者对感染性病变保持警惕并及时干预可能会增加EE治疗成功的机会。

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