- 作者：Ella H. Leung ; Ajay E. Kuriyan ; Harry W. Flynn Jr. ; hflynn@med.miami.edu" class="auth_mail" title="E-mail the corresponding author ; Nidhi Relhan ; Laura C. Huang ; Darlene Miller
- 刊名：American Journal of Ophthalmology
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：172
- 期：Complete
- 页码：45-50
- 全文大小：456 K
Design
Retrospective consecutive case series.
Methods
Setting: Tertiary referral center. Patient Population: Sixteen eyes of 16 patients with at least 2 consecutive positive vitreous cultures between 1981 and 2015. Interventions: Intravitreal antifungal injection, pars plana vitrectomy (PPV). Main Outcome Measure: Clinical settings, microbiologic isolates, BCVA.
Results
The most common clinical settings were after cataract surgery (9/16, 56%), glaucoma surgery (4/16, 25%), and trauma (2/16, 13%). The most common single fungal isolate was Candida (4/16, 25%), but 75% of all isolates were molds. Treatment for presumed bacterial endophthalmitis was given initially in 14 patients (88%). All patients underwent a vitrectomy during the course of their treatment, and all received intravitreal or systemic antifungal therapy. The mean initial BCVA was 1.76 ± 0.9 logMAR (Snellen equivalent ≈20/1200), and the mean final BCVA was 1.84 ± 1.2 logMAR (≈20/1400, P = .83). The 9 patients (56%) who had intraocular lens (IOL) and capsular bag removals had better final BCVAs than those who did not (P = .011). The BCVAs were similar in eyes with yeast and mold (P = .37). The visual acuity at the last follow-up was ≥20/40 in 13% (2/16), ≥20/400 in 50% (8/16), and no light perception in 25% (4/16).
Conclusions
Candida was the single most common isolate, but the majority of isolates were molds. Eyes managed with PPV and removal of the IOL and capsular bag had better visual outcomes. Persistently culture-positive fungal endophthalmitis was associated with poor final visual acuities.