玻璃体注射后眼内炎:发病率、特征、处理和结果。

IF 1.8 4区 医学 Q3 OPHTHALMOLOGY
Journal of Ophthalmology Pub Date : 2023-11-06 eCollection Date: 2023-01-01 DOI:10.1155/2023/9212524
Bar Davidov, Avi Ohayon, Omer Trivizki, Shulamit Schwartz, Shiri Shulman
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引用次数: 0

摘要

目的:玻璃体注射后眼内炎是一种罕见但具有破坏性的并发症。在此,我们报告了两个医疗中心的静脉注射性眼内炎的发病率、临床和微生物学特征以及视力结果。方法:对2018年1月至2019年12月在两家大型医疗中心接受玻璃体内注射的所有患者进行ivi后眼内炎的分析。结果:51356例静脉注射后眼内炎23例,总发生率为0.045%。从静脉注射到出现症状的中位间隔为2天(IQR: 1-5)。56%的病例培养呈阳性(革兰氏阳性菌100%,凝固酶阴性葡萄球菌76%)。与较高培养阳性率相关的参数包括玻璃体切除术期间采集的样本、玻璃体涂片上的白细胞、就诊前12个月内静脉注射次数以及从最后一次静脉注射到诊断抽样的时间间隔。在6和12个月的随访中,VA (logMAR)的中位变化分别为-1.10 (IQR:(-1.32)-(-0.40))和-1.02 (IQR:(-1.10)-(-0.30))。就诊时较年轻和较好的BCVA与较好的VA结果相关,而阳性培养结果和全身类固醇治疗均与较差的视力结果相关。我们发现作为主要手术的PPV和TAI在视觉结果上没有差异。结论:体外注射后眼内炎是一种罕见的并发症,大多数患者不能恢复其初始的眼内炎。某些参数(临床、微生物学和治疗)可以帮助预测结果并指导诊断和治疗决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postintravitreal Injection Endophthalmitis: Incidence, Characteristics, Management, and Outcome.

Purpose: Postintravitreal injection (IVI) endophthalmitis is a rare but devastating complication. Herein, we report the incidence ,and clinical and microbiological characteristics, as well as the visual outcome, in IVIs endophthalmitis in two medical centers.

Methods: All patients undergoing intravitreal injections between 1/2018 and 12/2019 in two large medical centers were analyzed for post-IVI endophthalmitis.

Results: Of the total of 51,356 IVIs performed, 23 cases of post-IVI endophthalmitis were diagnosed, yielding an overall incidence of 0.045%. The median interval from IVI to symptoms onset was 2 days (IQR: 1-5). Cultures were positive in 56% of the cases (100% Gram-positive bacteria and 76% coagulase-negative staphylococcus). Parameters associated with higher culture-positive rates included samples taken during vitrectomy, WBC on vitreous smear, the number of IVIs in the 12 months prior to presentation, and the time interval from last IVI to diagnostic sampling. At 6- and 12-month follow-up, the median change in VA (logMAR) was -1.10 (IQR: (-1.32)-(-0.40)) and -1.02 (IQR: (-1.10)-(-0.30)), respectively. Younger age and better BCVA at presentation were associated with better VA outcome, while positive culture result and systemic steroids treatment were each associated with the worse visual outcome. We found no difference in visual outcomes between PPV and TAI as a primary procedure.

Conclusion: Post-IVI endophthalmitis is a rare complication, and most patients do not regain their initial VA. Certain parameters (clinical, microbiological, and therapeutic) may help anticipate the outcome and guide decision making regarding diagnosis and treatment.

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来源期刊
Journal of Ophthalmology
Journal of Ophthalmology MEDICINE, RESEARCH & EXPERIMENTAL-OPHTHALMOLOGY
CiteScore
4.30
自引率
5.30%
发文量
194
审稿时长
6-12 weeks
期刊介绍: Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.
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