Abstract：
OBJECTIVE: To investigate whether the clinical characteristics, treatment and prognosis of endogenous infectious endophthalmitis (EIE) have changed over the past 5 years.
METHODS: Retrospectively analyze all articles about EIE published in the PubMed, Web of Science, and Embase databases from 2017 to 2021.
RESULTS: A total of 128 patients and 147 eyes (46 left and 60 right) were included in the study. The mean age at diagnosis was 51 ± 19 years. The most common risk factors were diabetes and intravenous drug use. From 2017 to 2021, Klebsiella was the most common pathogenic microorganism (22%), and vitreous culture had the highest positivity rate. The most common complaint was blurred vision. The mean visual acuity (logMAR) at onset was 2.84, and the clinical symptoms were vitreal inflammation and opacity (63%), ocular pain (37%), and conjunctival congestion (36%). The ocular inflammation could be reduced by intraocular antibiotics or vitrectomy. However, the visual prognosis, with a mean logMAR of 2.73; only 50% of the eyes reached a visual acuity level of finger count and above. Changes in diagnostics over the past 5 years have mainly manifested as more diverse microorganism culture methods. In addition to conventional culture methods, PCR, sputum culture and aqueous humour culture are also commonly used for the diagnosis of pathogenic bacteria, improving the positive culture rate and visual prognosis.
CONCLUSIONS: The prognosis of EIE is poor. It is recommended to pay attention to the pathogenic bacteria culture results and accompanying systemic diseases and to diagnose and treat patients as soon as possible.
METHODS: Retrospectively analyze all articles about EIE published in the PubMed, Web of Science, and Embase databases from 2017 to 2021.
RESULTS: A total of 128 patients and 147 eyes (46 left and 60 right) were included in the study. The mean age at diagnosis was 51 ± 19 years. The most common risk factors were diabetes and intravenous drug use. From 2017 to 2021, Klebsiella was the most common pathogenic microorganism (22%), and vitreous culture had the highest positivity rate. The most common complaint was blurred vision. The mean visual acuity (logMAR) at onset was 2.84, and the clinical symptoms were vitreal inflammation and opacity (63%), ocular pain (37%), and conjunctival congestion (36%). The ocular inflammation could be reduced by intraocular antibiotics or vitrectomy. However, the visual prognosis, with a mean logMAR of 2.73; only 50% of the eyes reached a visual acuity level of finger count and above. Changes in diagnostics over the past 5 years have mainly manifested as more diverse microorganism culture methods. In addition to conventional culture methods, PCR, sputum culture and aqueous humour culture are also commonly used for the diagnosis of pathogenic bacteria, improving the positive culture rate and visual prognosis.
CONCLUSIONS: The prognosis of EIE is poor. It is recommended to pay attention to the pathogenic bacteria culture results and accompanying systemic diseases and to diagnose and treat patients as soon as possible.
摘要：
目的：探讨临床特征、内源性感染性眼内炎（EIE）的治疗和预后在过去5年中发生了变化。
方法：回顾性分析PubMed上发表的所有关于EIE的文章，WebofScience,和Embase数据库从2017年到2021年。
结果：本研究共纳入128例患者和147只眼（左侧46只眼和右侧60只眼）。诊断时的平均年龄为51±19岁。最常见的危险因素是糖尿病和静脉用药。从2017年到2021年，克雷伯菌是最常见的病原微生物（22％），玻璃体培养阳性率最高。最常见的抱怨是视力模糊。发病时的平均视力（logMAR）为2.84，临床症状为玻璃体炎症和混浊（63%），眼痛（37%），结膜充血（36%）。眼内抗生素或玻璃体切除术可以减少眼部炎症。然而,视觉预后，平均logMAR为2.73；只有50％的眼睛达到手指数及以上的视力水平。过去5年的诊断变化主要表现为微生物培养方法更加多样化。除了传统的培养方法，PCR,痰液培养和房水培养也常用于病原菌的诊断，提高阳性培养率及视力预后。
结论：EIE的预后较差。建议注意病原菌培养结果和伴随的全身性疾病，并尽快诊断和治疗患者。
方法：回顾性分析PubMed上发表的所有关于EIE的文章，WebofScience,和Embase数据库从2017年到2021年。
结果：本研究共纳入128例患者和147只眼（左侧46只眼和右侧60只眼）。诊断时的平均年龄为51±19岁。最常见的危险因素是糖尿病和静脉用药。从2017年到2021年，克雷伯菌是最常见的病原微生物（22％），玻璃体培养阳性率最高。最常见的抱怨是视力模糊。发病时的平均视力（logMAR）为2.84，临床症状为玻璃体炎症和混浊（63%），眼痛（37%），结膜充血（36%）。眼内抗生素或玻璃体切除术可以减少眼部炎症。然而,视觉预后，平均logMAR为2.73；只有50％的眼睛达到手指数及以上的视力水平。过去5年的诊断变化主要表现为微生物培养方法更加多样化。除了传统的培养方法，PCR,痰液培养和房水培养也常用于病原菌的诊断，提高阳性培养率及视力预后。
结论：EIE的预后较差。建议注意病原菌培养结果和伴随的全身性疾病，并尽快诊断和治疗患者。
