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首页> 外文期刊>Clinical and experimental ophthalmology >Predictors of visual outcome and the role of early vitrectomy in streptococcal endophthalmitis
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Predictors of visual outcome and the role of early vitrectomy in streptococcal endophthalmitis

机译：视觉结果的预测因素及早期玻璃体切除在链球菌内炎的作用

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Abstract Importance Streptococcal endophthalmitis has devastating sequelae. This study aims to identify factors which may be targeted to optimize patient outcomes. Background This study investigated characteristics influencing visual outcomes and the role of early vitrectomy. Design Retrospective observational case series of consecutive patients was conducted. Participants All patients with a culture‐positive diagnosis of streptococcal endophthalmitis treated at a tertiary ophthalmology referral centre between July 1997 and February 2012 were included. Methods Patient records were reviewed and data collected on their presentation, examination, microbiology results, procedures and final outcome. Main Outcome Measures Visual acuity (VA) and enucleation/evisceration were measured. Results Of the 101 patients, 35.6% presented with a VA of hand movements and 42.6% with light perception (LP). Final VA was poor (6/60 or worse) in 77.6% and 24.7% were enucleated/eviscerated. Presenting VA of LP or worse ( P ?=?0.008), no view of fundus ( P ?=?0.001), large number of organisms ( P ??0.001), recognition of Streptococcus on Gram stain ( P ?=?0.010), heavy growth on culture ( P ??0.001) and more intravitreal injections ( P ?=?0.038) were significantly associated with poor visual outcome (6/60 or worse). Presenting VA of LP or worse ( P ?=?0.042) and non‐viridans Streptococcus species ( P ?=?0.002) were significantly associated with enucleation/evisceration. Fifteen patients (14.9%) had early vitrectomy within 48?h which was not associated with poor final VA or removal of the eye ( P ?=?1.000). Conclusions and Relevance Early vitrectomy did not influence visual outcome in this cohort. Microbiology results were useful in predicting poor outcomes, and may allow clinicians to make early treatment decisions and provide prognostic information for patients.
机译：摘要Indeptococal内膜炎具有破坏性后遗症。本研究旨在识别可能有针对性的因素优化患者结果。背景技术本研究研究了影响视觉结果的特征和早期玻璃体切除术的作用。设计回顾性观察案例串行患者系列。参与者所有患有在1997年7月至2012年7月至2012年2月间在第三次眼科转诊中心治疗的培养阳性诊断的患者。方法审查患者记录和收集其介绍，检查，微生物学结果，程序和最终结果的数据。主要结果测量视力（VA）和测量enucleation / Evisceration。 101例患者的结果，35.6％呈现出VA动作运动和42.6％，灵敏度（LP）。最终的VA差（6/60或更差），77.6％，24.7％是enucleated / Deciacherated。呈现LP或更差的VA（p？= 0.008），没有眼底（p？= 0.001），有大量的生物（p？＆ 0.001），克斑染色的链球菌（p？=？ 0.010），培养物的重增长（p≤≤0.001）和更多的玻璃体内注射（p？= 0.038）显着与视觉结果差（6/60或更糟）显着相关。呈现LP或更差（P？= 0.042）和非血管内甘肽（P？= 0.002）显着与enucleation /展示有关。十五名患者（14.9％）在48℃内具有早期玻璃切除术，其与最终VA差或移除眼睛（P？=？1.000）无关。结论和相关性早期玻璃体切除术不会影响这一群组的视觉结果。微生物学结果可用于预测差的结果，并可能允许临床医生制定早期治疗决策并为患者提供预后信息。

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