Infectious endophthalmitis: review of 420 cases.
Infectious endophthalmitis: review of 420 cases.
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感染性内脑膜：420例审查。
DOI：
10.2147/opth.s39934
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Yospaiboon Y
中科院分区：
文献类型：
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作者：
Bhoomibunchoo C;Ratanapakorn T;Sinawat S;Sanguansak T;Moontawee K;Yospaiboon Y
泰国东北部一家大型转诊中心的眼内炎患者的致病菌和视力结果特征。回顾性分析1983 ~ 2007年收治的感染性眼内炎病例。记录患者资料，包括年龄、性别、眼部损伤史、既往治疗和症状持续时间。眼部检查包括受累侧、前房反应、玻璃体混浊和眼内异物的存在。对前房穿刺和/或玻璃体轻叩进行涂片和培养。在前房穿刺和/或玻璃体轻叩时给予眼内抗生素。如有需要，行玻璃体切除术和/或晶状体切除术。比较治疗前的初始视力和最终最佳矫正视力。共回顾420例眼内炎病例，其中181例（43.1%）感染前有眼外伤；术后发生眼内炎135例（32.2%）；122例（29.1%）培养阳性。检出细菌114例（93.4%），真菌8例（6.6%）。常见病原菌为表皮葡萄球菌。玻璃体切除联合眼内抗生素治疗189例（45.0%），单用眼内抗生素治疗69例（16.4%）。大多数病例与外伤和眼内手术有关。引起感染性眼内炎最常见的细菌是表皮葡萄球菌。多数病例采用玻璃体切除联合眼内抗生素治疗。最终的视力结果似乎因眼内炎的类型而异。
To characterize the causative pathogens and the visual outcomes among patients with endophthalmitis at a large referral center in northeastern Thailand. All cases of infectious endophthalmitis treated between 1983 and 2007 were reviewed retrospectively. The patient data – including age, sex, history of ocular injuries, previous treatment and duration of the symptoms – were recorded. The ocular examination included affected side, anterior chamber reaction, vitreous haze, and presence of intraocular foreign bodies. Smears and cultures were prepared from anterior chamber paracentesis and/or vitreous tapping. Intraocular antibiotics were administered at the time of anterior chamber paracentesis and/or vitreous tapping. Vitrectomy and/or lensectomy were performed when indicated. Initial visual acuity before treatment and the final best-corrected vision were compared. A total of 420 cases of endophthalmitis were reviewed: 181 cases (43.1%) had ocular trauma before the infection; 135 (32.2%) developed endophthalmitis after intraocular surgery; and, 122 (29.1%) had a positive culture. Bacteria were isolated in 114 cases (93.4%) and fungi were noted in eight (6.6%). The common causative bacterium was Staphylococcus epidermidis. Combined vitrectomy and intraocular antibiotics were performed in 189 cases (45.0%), whereas 69 cases (16.4%) were treated with intraocular antibiotics alone. Most of the reviewed cases were associated with trauma and intraocular surgery. The most frequently encountered bacterium causing infectious endophthalmitis was S. epidermidis. Most cases were treated with combined vitrectomy and intraocular antibiotics. The final visual outcomes seem to vary according to the type of endophthalmitis.