Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center

被引:19
作者
Karacal H. [1 ]
Kymes S.M. [1 ]
Apte R.S. [1 ,2 ]
机构
[1] Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO 63105
[2] Barnes Retina Institute, Washington University School of Medicine, St. Louis, MO 63105
关键词
Endophthalmitis; Retina; Vitrectomy;
D O I
10.1007/s10792-007-9068-3
中图分类号
学科分类号
摘要
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. © Springer Science+Business Media, Inc. 2007.
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页码:251 / 259
页数:8
相关论文
共 19 条
[1]  
West E.S., Behrens A., McDonnell P.J., Tielsch J.M., Schein O.D., The incidence of endophthalmitis after cataract surgery among the U.S. Medicare population increased between 1994 and 2001, Ophthalmology, 112, 8, pp. 1388-1394, (2005)
[2]  
Eter N., Krohne T.U., Holz F.G., New pharmacologic approaches to therapy for age-related macular degeneration, BioDrugs, 20, 3, pp. 167-179, (2006)
[3]  
Jonas J.B., Intravitreal triamcinolone acetonide: A change in a paradigm, Ophthalmic Res, 38, 4, pp. 218-245, (2006)
[4]  
A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis, Arch Ophthalmol, 113, 12, pp. 1479-1496, (1995)
[5]  
Taban M., Behrens A., Newcomb R.L., Nobe M.Y., Saedi G., Sweet P.M., McDonnell P.J., Acute endophthalmitis following cataract surgery: A systematic review of the literature, Arch Ophthalmol, 123, 5, pp. 613-620, (2005)
[6]  
Cooper B.A., Holekamp N.M., Bohigian G., Thompson P.A., Case-control study of endophthalmitis after cataract surgery comparing scleral tunnel and clear corneal wounds, Am J Ophthalmol, 136, 2, pp. 300-305, (2003)
[7]  
Miller J.J., Scott I.U., Flynn Jr. H.W., Smiddy W.E., Newton J., Miller D., Acute-onset endophthalmitis after cataract surgery (2000-2004): Incidence, clinical settings, and visual acuity outcomes after treatment, Am J Ophthalmol, 139, 6, pp. 983-987, (2005)
[8]  
Ng J.Q., Morlet N., Pearman J.W., Constable I.J., McAllister I.L., Kennedy C.J., Isaacs T., Semmens J.B., Management and outcomes of postoperative endophthalmitis since the endophthalmitis vitrectomy study: The Endophthalmitis Population Study of Western Australia (EPSWA)'s fifth report, Ophthalmology, 112, 7, pp. 1199-1206, (2005)
[9]  
Busbee B.G., Recchia F.M., Kaiser R., Nagra P., Rosenblatt B., Pearlman R.B., Bleb-associated endophthalmitis: Clinical characteristics and visual outcomes, Ophthalmology, 111, 8, pp. 1495-1503, (2004)
[10]  
Wu P.C., Kuo H.K., Li M., Lai I.C., Fang P.C., Lin S.A., Shin S.J., Chen Y.J., Teng M.C., Nosocomial postoperative endophthalmitis: A 14-year review, Graefes Arch Clin Exp Ophthalmol, 244, 8, pp. 920-929, (2006)