Abstract：
This study assessed prognostic factors and the role of vitrectomy in patients with subretinal abscesses secondary to K. pneumoniae endophthalmitis. We reviewed published studies, including three cases from our cohort. Among 50 eyes, 26 had poor visual outcomes (final visual acuity <20/800, eyeball removal, or phthisis bulbi). Poor outcomes correlated with delayed ocular symptom-to-diagnosis time, initial visual acuity <20/800, severe vitritis, and macular involvement of abscesses (p < 0.001, p = 0.008, p < 0.001, and p = 0.033, respectively). Vitrectomy had a trend towards reducing eyeball removal and phthisis bulbi rates compared with non-vitrectomy (10.8% vs 30.8%, p = 0.181). However, the final visual acuity was not different and the rate of retinal detachment tended to be higher in vitrectomized eyes (45.9% vs 15.4%, p = 0.095). The study suggested that vitrectomy and drainage of K. pneumoniae subretinal abscesses could be avoided in patients with a mild degree of vitritis.
摘要：
这项研究评估了肺炎克雷伯菌眼内炎继发视网膜下脓肿患者的预后因素和玻璃体切除术的作用。我们回顾了已发表的研究，包括我们队列中的三个病例。在50只眼睛中，26人视力不良(最终视力<20/800，眼球摘除，或phthisisbulbi)。不良结果与眼部症状到诊断时间延迟相关，初始视力<20/800，严重的玻璃体炎，和脓肿的黄斑受累（分别为p<0.001，p=0.008，p<0.001和p=0.033）。与非玻璃体切除术相比，玻璃体切除术有降低眼球摘除率和远孕率的趋势(10.8%vs30.8%，p=0.181）。然而,玻璃体切除眼的最终视力没有差异，视网膜脱离率趋于更高（45.9%vs15.4%，p=0.095)。研究表明，轻度玻璃体炎患者可以避免玻璃体切割和引流肺炎克雷伯菌视网膜下脓肿。
