目的我们的研究旨在描述内源性眼内炎的临床特征,关注患者的人口统计学,感染源,微生物概况,临床结果,以及影响最终视觉结果的因素。方法回顾性分析2011年1月至2020年12月在马来西亚半岛东海岸的两家三级医院住院的60例内源性眼内炎患者的68只眼资料。分析包括评估患者年龄,性别,偏侧性,危险因素,感染起源,呈现和最终的视力,微生物结果,治疗反应,以及影响最终视觉结果的因素。结果患者队列的平均年龄为54.9±13.3岁。女性比男性更容易患内源性眼内炎(33,55.0%vs.27、45.0%)。27例患者(45.0%)出现左眼内源性眼内炎,而25名患者(41.7%)的右眼有这种病,8例患者(13.3%)有双侧受累.大多数患者有潜在的易感条件,以糖尿病为主(53,88.3%)。42例患者(70.0%)确定感染源,其中尿路感染占大多数(11,18.3%)。克雷伯菌属(14,22.7%)是主要病原体,与肝脓肿病例显著相关。在这个系列中,大多数患者的表现较差,最终视力低于3/60(56,82.4%和53,77.9%,分别)。36眼(52.9%)行玻璃体切除术,导致只有四只眼睛(11.11%)达到优于6/12的最终视力。呈现视敏度被确定为促成盲最终视觉结果的因素(r=0.707,p<0.001)。结论女性比男性更常受到内源性眼内炎的影响。克雷伯菌属是最常见的分离微生物,通常与肝脓肿有关。尿路感染是最常见的诱发因素。大多数患者的视力和最终视力都很差,其中视力不佳是失明视力结果的重要指标。
Purpose Our study aimed to describe the clinical profile of endogenous endophthalmitis, focusing on patient demographics, infection sources, microbial profiles, clinical outcomes, and factors affecting the final visual outcome. Methods A retrospective review was performed on data from 68 eyes of 60 patients diagnosed with endogenous endophthalmitis and hospitalized in two tertiary hospitals on the East Coast of Peninsular Malaysia from January 2011 to December 2020. The analysis encompassed evaluating patient age, gender, laterality, risk factors, infection origins, presenting and final visual acuity, microbial results, treatment responses, and factors affecting final visual outcomes. Results The average age of the patient cohort was 54.9 ± 13.3 years. Females were more likely to have endogenous endophthalmitis than males (33, 55.0% vs. 27, 45.0%). Twenty-seven patients (45.0%) presented with endogenous endophthalmitis in the left eye, while 25 patients (41.7%) had it in the right eye, and eight patients (13.3%) had bilateral involvement. Most patients had underlying predisposing conditions, predominantly diabetes mellitus (53, 88.3%). Infection sources were identified in 42 patients (70.0%), out of which urinary tract infections account for the majority (11, 18.3%). Klebsiella species(14, 22.7%) were the leading pathogens and were significantly associated with liver abscess cases. In this series, the majority of patients had poor presenting and final visual acuity of worse than 3/60 (56, 82.4% and 53, 77.9%, respectively). Thirty-six eyes (52.9%) underwent vitrectomy, resulting in only four eyes (11.11%) achieving final visual acuity better than 6/12. Presenting visual acuity was identified as the factor contributing to the blind final visual outcome (r = 0.707, p < 0.001). Conclusion Females were found to be more commonly affected by endogenous endophthalmitis than males. Klebsiella species were the most commonly isolated microorganisms and were typically associated with liver abscesses. Urinary tract infection was the most common predisposing factor. A majority of the patients had poor presenting and final visual acuity, in which poor visual acuity is a significant indicator of blind visual outcomes.