Relation between stage of endogenous fungal endophthalmitis and prognosis
Relation between stage of endogenous fungal endophthalmitis and prognosis
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DOI：
10.1007/s00417-005-0182-5
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发表时间：
2006-07-01
影响因子：
2.7
通讯作者：
Tanaka, Minoru
中科院分区：
文献类型：
--
作者：
Takebayashi, Hiroshi;Mizota, Atsushi;Tanaka, Minoru
虽然已经发表了许多关于内源性真菌性眼内炎（EFE）的危险因素和治疗方法的研究，但只有少数研究发表了EFE在初次检查时的分期与预后之间的关系。因此，本研究的目的是确定EFE在初次检查时的分期与眼外伤之间的关系。共对58例（40例男性，18例女性）EFE患者的103只眼进行了研究，这些患者在20年期间（1984-2004年）进行了检查。初步检查时EFE的严重程度分为四个阶段。此外，还分析了真菌的类型、一般状况、初始和最终视力、前节和后节的发现、潜在真菌感染、从初始症状到首次就诊的持续时间、静脉内高营养（IVH）史、念珠菌检测系统的结果和β-D-葡聚糖水平。在40例患者的血液中最初检测到白色念珠菌。EFE的阶段随着从最初症状到开始治疗的时间的增加而提前。最终视力与初次检查时EFE的分期显着相关。21例患者中有20例血β-D-葡聚糖阳性，42例（90%）接受IVH。由于EFE的分期随着初始症状和治疗开始之间的时间而提前，并且由于EFE分期与最终视力之间的高度相关性，因此尽快开始治疗非常重要。因此，对于有视觉症状和易受机会性感染的患者，强烈建议早期咨询眼科医生。
Although many studies have been published on the risk factors and therapies for endogenous fungal endophthalmitis (EFE), only a few have been published on the relationship between the stage of EFE at the initial examination and the prognosis. Thus, the purpose of this study was to determine the relation between the stage of EFE at the initial examination and the prognosis.A total of 103 eyes of 58 patients (40 men, 18 women) with EFE, examined over a 20-year period (1984-2004), were studied. The severity of the EFE at the initial examination was classified into four stages. In addition, the type of fungus, general status, initial and final visual acuity, findings of the anterior and posterior segments, latent fungal infection, duration from initial symptoms to initial visit, history of intravenous hyperalimentation (IVH), results of the Candida Detection System, and beta-D-glucan levels were analyzed.More than 95% of the patients had some type of underlying disorder. Candida albicans was detected initially in the blood in 40 patients. The stage of the EFE advanced as the time from the initial symptoms to the beginning of therapy increased. The final visual acuity was significantly correlated with the stage of EFE at the initial examination. In 20 of 21 patients, blood beta-D-glucan was positive, and 42 patients (90%) were receiving IVH.Because the stage of EFE advanced with the time between the initial symptoms and the beginning of therapy, and because of the high correlation between the stage of EFE and the final visual acuity, it is very important that treatment be begun as soon as possible. Thus, in patients with visual symptoms and susceptible to opportunistic infections, an early consultation with an ophthalmologist is highly recommended.