Cotton Caroline, Hoyek Sandra, McTavish Sloane, Tieger Marisa, Chaaya Celine, Rossin Elizabeth, Wu David, Harris James, Patel Nimesh A
The University of Virginia School of Medicine, Charlottesville, VA, USA.
Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
J Vitreoretin Dis. 2025 Sep 2:24741264251364818. doi: 10.1177/24741264251364818.
To evaluate B-scan echographic features of endophthalmitis for their correlation with disease characteristics and long-term vision outcomes. Patients diagnosed with endophthalmitis at Massachusetts Eye and Ear between 2011 and 2021 were recruited (N = 209). Data included demographics, infection source, initial therapy, and findings from culture isolates, best corrected visual acuity (BCVA), slit lamp, and B-scan ultrasonography. More patients with positive microbial cultures, versus those with negative cultures, had dense vitreous debris on initial B-scan ( = .008). Patients whose initial slit lamp examination provided difficult/no view into the anterior chamber had more frequent findings of retinal detachment (RD) and T-sign ( < .001 and = .016, respectively) and worse final mean BCVA ( < .001) versus patients with adequate views. Patients with dense vitreous opacities (VO) on initial B-scan had significantly worse initial mean BCVA versus patients with mild or moderate VO ( .001 and = .013, respectively) and had significantly worse final mean BCVA versus patients with mild VO ( .001). Final mean BCVA was significantly worse in patients with choroidal detachment (CD), RD, or T-sign than in patients without these features (each < .001). Reductions in VO and vitreous membranes were observed at 1 month postpresentation, whereas CD was significantly more common at 1 week and RD more common at 1 month postpresentation. Positive cultures, specific microbial species, and B-scan findings (dense VO, CD, RD, and T-sign) are independent predictors of worse vision outcomes in patients with endophthalmitis.
评估眼内炎的B超特征及其与疾病特征和长期视力预后的相关性。招募了2011年至2021年期间在马萨诸塞州眼耳医院被诊断为眼内炎的患者（N = 209）。数据包括人口统计学信息、感染源、初始治疗、培养分离物的结果、最佳矫正视力（BCVA）、裂隙灯检查和B超检查结果。与培养阴性的患者相比，培养阳性的患者在初次B超检查时玻璃体碎屑更浓密（P = 0.008）。与前房检查清晰的患者相比，初次裂隙灯检查难以看清或无法看清前房的患者视网膜脱离（RD）和T征的发生率更高（分别为P < 0.001和P = 0.016），最终平均BCVA更差（P < 0.001）。初次B超检查时玻璃体混浊（VO）浓密的患者与轻度或中度VO患者相比，初始平均BCVA明显更差（分别为P < 0.001和P = 0.013），与轻度VO患者相比，最终平均BCVA明显更差（P < 0.001）。有脉络膜脱离（CD）、RD或T征的患者最终平均BCVA明显比没有这些特征的患者差（均为P < 0.001）。就诊后1个月观察到VO和玻璃体膜减少，而CD在就诊后1周明显更常见，RD在就诊后1个月更常见。培养阳性、特定微生物种类和B超检查结果（浓密VO、CD、RD和T征）是眼内炎患者视力预后较差的独立预测因素。
