Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center
Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center
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DOI：
10.1007/s10792-007-9068-3
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发表时间：
2007-08-01
影响因子：
1.6
通讯作者：
Apte, Rajendra S.
中科院分区：
文献类型：
--
作者：
Karacal, Humeyra;Kymes, Steven M.;Apte, Rajendra S.
方法对2000年1月至2005年1月收治的所有原因的眼内炎患者进行回顾性分析。结果共诊断眼内炎67例。最常见的原因是白内障术后的眼内炎。大多数病例(79%)最初的治疗是玻璃体穿刺术和玻璃体内注射抗菌药物。玻璃体培养阳性32只眼(44.4%)，最常见的是凝固酶阴性葡萄球菌。61%的患者最终视力有所提高。超过三分之一(38%)的人视力比数手指还差。28只眼(39%)因眼内炎继发并发症而需行玻璃体切除手术。结论白内障手术仍是该大型三级转诊中心眼内炎的最常见原因。超过一半的病例通过玻璃体穿刺针活检和玻璃体内注射治愈了眼内炎。然而，超过三分之一的患者需要额外的玻璃体视网膜手术来治疗继发性并发症。超过三分之一的患者在眼内炎解决后出现无功能视力，这突显了在目前以办公室为基础的玻璃体内药物治疗视网膜疾病的扩大时代，这种情况的严重性。
Purpose To report a large, consecutive series of endophthalmitis of all causes managed at a tertiary referral retina center.Methods Retrospective chart review of all cases diagnosed with endophthalmitis that received reatment and follow-up between January 2000 and January 2005.Results A total of 67 patients were diagnosed with endophthalmitis. The most common cause was postoperative endopthalmitis after cataract surgery. Initial management was vitreous needle biopsy with intravitreal antimicrobial injection in a majority of cases (79%). Vitreous cultures were positive in 32 eyes (44.4%); the most common isolate was coagulase negative Staphylococci. Final visual acuity was improved in 61% of patients. More than a third (38%) had vision worse than count fingers. Twenty-eight eyes (39%) needed pars plana vitrectomy for secondary complications as a consequence of endophthalmitis.Conclusions Cataract surgery remains the most common cause of endophthalmitis in this large tertiary referral retina center. Endophthalmitis resolved with vitreous needle biopsy and intravitreal injections in more than half of the cases. However, more than a third of patients required additional vitreoretinal surgery for secondary complications. More than a third of patients had nonfunctional vision after the resolution of endophthalmitis, which highlights the severity of this condition in the current expanding era of office-based intravitreal pharmacotherapy for retinal diseases.