A multicentre prospective study of post-traumatic endophthalmitis

作者：Cornut Pierre Loic; Youssef El Bichara; Bron Alain; Thuret Gilles; Gain Philippe; Burillon Carole; Romanet Jean Paul; Vandenesch Francois; Maurin Max; Creuzot Garcher Catherine; Chiquet Christophe^*

来源：Acta Ophthalmologica, 2013, 91(5): 475-482.

DOI：10.1111/j.1755-3768.2011.02349.x

• endophthalmitis
• intraocular foreign body
• ocular trauma
• pars plana vitrectomy
• retinal detachment
• Staphylococcus

. Purpose: Study the clinical and microbiological characteristics and the prognostic factors of post-traumatic endophthalmitis. Methods: Seventeen eyes were included between 2004 and 2010, with clinical and microbiological data collected prospectively. Conventional cultures and panbacterial PCR were performed on aqueous and vitreous samples. Results: Clinical signs of endophthalmitis were observed soon after trauma (1.5 +/- 2.5days). Laceration with an intraocular foreign body (IOFB) was noted in 53% of the patients. At admission, all patients had aqueous humour (71%) and/or vitreous (53%) samples. Fifteen patients (88%) underwent a pars plana vitrectomy. Bacteria were identified in 77% of the cases: Staphylococcus epidermidis (n=5), Streptococcus (n=4), Bacillus (n=2), Pseudomonas stuzeri (n=1), and Streptococcus salivarius and Gemella haemolysans (multibacterial infection, n=1). Progression toward phthisis was observed in 35% of the cases; 41% of the patients recuperated visual acuity (VA) 20/40. A good final visual prognosis (20/40) was significantly associated with initial VA better than light perception (0% versus 70%, p=0.01) and absence of pupillary fibrin membrane (80% versus 20%, p=0.05). There was no correlation between visual prognosis and age, the type of laceration (corneal or scleral) or presence of an IOFB. We found a statistical trend toward an association between bacterial virulence and poor final VA. Conclusion: This series showed that better final VA outcomes were associated with initial VA better than light perception, S.epidermidis or culture-negative cases and absence of retinal detachment during the clinical course.

• 出版日期2013-8