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ORIGINAL ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 14  |  Page : 1658-1665

Clinical Analysis of 1593 Patients with Infectious Endophthalmitis: A 12-Year Study at a Tertiary Referral Center in Western China


1 Department of Ophthalmology, West China Hospital of Sichuan University; Department of Optometry and Visual Science, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
2 Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China
3 Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China
4 Department of Health Policy and Management, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China

Correspondence Address:
Dr. Zhu-Ping Xu
Department of Ophthalmology, West China Hospital of Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan 610041
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.235866

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Background: Infectious endophthalmitis is a severe ocular inflammation which can cause devastating visual loss. The aim of the study was to identify the demographic and clinical features of infectious endophthalmitis in Western China for better prophylaxis and treatment of this disease. Methods: A retrospective, cross-sectional study was conducted based on the medical records of inpatients having infectious endophthalmitis in a tertiary referral center in Western China between 2005 and 2016. Results: The common cause of infectious endophthalmitis was trauma (82.6%), endogenous (7.8%), ophthalmic surgery (6.9%), and corneal ulcer with perforation (2.7%). These four etiological groups differed in age, gender, enucleation rate, visual outcome, etc. The number of cases in the first 6 years accounted for 38.7% of the total collection, which in the second 6 years accounted for 61.3%. The etiology patterns were different between these two periods. Altogether 51.3% of patients received pars plana vitrectomy, 13.9% of patients underwent evisceration, and the remaining 34.8% received other treatments. Of the 670 cases that had culture results, 266 (39.7%) were culture positive and 177 (66.5%) were Gram-positive organisms, 64 (24.1%) were Gram-negative organisms, 11 (4.1%) had fungal infection, and 14 (5.3%) were infected by multiple pathogens. Conclusions: There was an upward trend of the occurrence of infectious endophthalmitis in Western China for the past decade. The demographic and clinical characteristics of infectious endophthalmitis in Western China had its own characteristics and differed from those of developed countries. Here, open globe trauma was the most common cause of endophthalmitis, most traumatic endophthalmitis patients were male, and most of the injuries were work related, implicate that we should strengthen the education and application of ocular safety regulation specifically targeting the workplace.

 

 Abstract in Chinese

中国西部121593例感染性眼内炎临床分析

摘要

背景:感染性眼内炎是一种严重危害视力的眼部感染性疾病。本研究着眼于分析中国西部一大型转诊中心12年来收治的感染性眼内炎患者的临床特点,为预防和早期治疗提供依据。

方法:回顾分析2005至2016年间四川大学华西医院眼科住院治疗的感染性眼内炎患者1593例的病例资料。

结果:感染性眼内炎的常见致病因素为外伤(82.6%),内源性(7.8%),眼科手术(6.9%)和角膜溃疡穿孔(2.7%)。这4种眼内炎在年龄、性别、眼内容物剜除率和视力等方面有所区别。前6年患者数量占38.7%,后6年占61.3%,这两个时间段的致病因素也有所差别。51.3%的患者接受了经睫状体平坦部玻璃体切除术,13.9%的患者行眼内容物剜除术,其余34.8%的患者接受了其他治疗。670例患者有培养结果,其中266例(24.1%)培养阳性。在这266例培养阳性患者中,177例(66.5%)是革兰阳性菌,64例(24.1%)是革兰阴性菌,11例(4.1%)是真菌,还有14例(5.3%)是多重感染。

结论:在过去的十年中,中国西部的感染性眼内炎发病有上升的趋势,其人口学和临床特点有别于发达国家,有其地域特色。这里开放性眼外伤是感染性眼内炎最常见的致病因素,大部分外伤后眼内炎为男性患者且与劳动作业相关。这提示我们应该加强工作场所的眼安全规范教育和采取眼外伤预防措施。



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