目的:报告临床发现,危险因素,治疗,与非链球菌相关的培养阳性眼内炎相比,与链球菌眼内炎相关的视觉结局。
方法:2009年1月1日至2018年1月1日在杜克大学眼科中心(达勒姆,北卡罗来纳州)从最初诊断开始至少六个月的随访。包括患者人口统计学在内的临床数据,眼部病史,演示前的基线矫正视力(VA),时间介绍,展示考试结果,VA在介绍时,眼内炎的假定病因,医疗和外科管理,提取随访6个月时的VA并进行统计学分析。
结果:确定了56例培养阳性眼内炎患者的56只眼。链球菌眼(n=18)出现时眼内压(IOP)升高(p=0.002),演示时的平均VA(Snellen)(20/14159vs.20/3098,p<0.001),更糟糕的是六个月时的VA(Snellen)(20/3475vs.20/235,p<0.001)与非链球菌病例(n=38)相比。提交时间(天)(中位数,IQR)在接受青光眼手术治疗的链球菌(2241(836,3709)与3(2,31),p=0.003)和非链球菌眼内炎(1236(125,3582)与6(4,25),p<0.0001)。根据治疗,链球菌和非链球菌眼在六个月时的VA没有差异。结论:链球菌是外源性眼内炎的罕见但重要的病因,在我们的研究中,与非链球菌相比,它们与更差的视觉结局相关.任何青光眼手术史,即使是几年前执行的程序,在评估有眼部症状的患者时应该引起。
OBJECTIVE: Report the clinical findings, risk factors, treatment, and visual outcomes associated with Streptococcus
endophthalmitis in comparison to culture-positive
endophthalmitis associated with non-Streptococcus species.
METHODS: A retrospective chart review of adults between 18 and 89 years of age diagnosed with exogenous culture-positive endophthalmitis between January 1, 2009, and January 1, 2018, at the Duke Eye Center (Durham, North Carolina) with at least six months of follow-up from time of initial diagnosis was conducted. Clinical data including patient demographics, ocular history, baseline corrected visual acuity (VA) prior to presentation, time to presentation, presenting exam findings, VA at presentation, presumed etiology of
endophthalmitis, medical and surgical management, and VA at the six-month follow-up was extracted and statistically analyzed.
RESULTS: Fifty-six eyes from 56 patients with culture-positive
endophthalmitis were identified. Eyes with Streptococcus (n=18) had elevated intraocular pressure (IOP) at presentation (p=0.002), worse mean VA (Snellen) at presentation (20/14159 vs. 20/3098, p<0.001), and worse mean VA (Snellen) at six months (20/3475 vs. 20/235, p<0.001) compared to non-Streptococcus cases (n=38). Time to presentation (days) (median, IQR) was longer in eyes that underwent glaucoma surgery for both Streptococcus (2241 (836, 3709) vs. 3 (2, 31), p=0.003) and non-Streptococcus endophthalmitis (1236 (125, 3582) vs. 6 (4, 25), p<0.0001). There was no difference in VA at six months between Streptococcus and non-Streptococcus eyes based on treatment. Conclusions: Streptococci are rare but important causes of exogenous
endophthalmitis, and in our study, they were associated with worse visual outcomes than non-Streptococci. A history of any glaucoma surgery, even procedures performed years earlier, should be elicited when evaluating patients with ocular symptoms.