| Objective:This article retrospectively studied the cases of endogenous endophthalmitis in our hospital in the past 12 years,and analyzed the clinical characteristics and related factors affecting prognostic vision,in thereby to provide possible evidence-based medicine evidence for clinical work.Methods:Uncontrolled retrospective case study.A total of 42 patients(47 eyes)with endogenous endophthalmitis admitted to the Second Hospital of Jilin University from October 2008 to October 2020 were selected to collect the general information,basic diseases,symptoms and signs,etiological examination,treatment results,visual acuity and complications of the patients.SPSS23.0 statistical software was used to analyze the data,and the qualitative data were expressed as constituent ratio(%).Qualitative variables were tested by X2 test and Fisher’s exact probability method.Bariate Logistic regression analysis was used to analyze the visual acuity related factors that might affect the visual prognosis of endogenous endophthalmitis.Results:Forty-two patients with 47 eyes were enrolled,with an average age of 53.64±11.50 years old.There were 30 males(30/42,71.4%)and 12females(12/42,28.6%).Five cases(5/42,11.9%)were binocular;There were 37 cases(37/42,88.1%)in one eye,20 cases(20/37,54.1%)in right eye,and 17 cases(17/37,45.9%)in left eye.18 patients(18/42,42.9%)had diabetes and seven patients(7/42,16.7%)had hypertension.The primary source of infection in the patients was digestive system in 23cases(23/42,54.8%),respiratory system in eight cases(8/42,19%),and other system in 11 cases(11/42,26.2%).Ten cases(10/42,23.8%)were cultured positive,including five cases(5/42,11.9%)of Klebsiella pneumoniae,three cases(3/42,7.1%)of Candida albicans,one case(1/42,2.4%)of Enterococcus faecium,and one case(1/42,2.4%)of Gram-negative bacillus.There were 32 cases(32/42,76.2%)with unknown pathogenic bacteria.During the hospital stay,ten eyes received PPV,14 eyes received IVI+PPV,18 eyes received IVI,of which five eyes did not receive eye surgery.Follow-up results of 47 eyes of 42 patients were as follows: visual acuity ≥0.05 in six eyes,manual /10 cm in six eyes,index /10 cm in six eyes,visual sense in seven eyes,no light sense in 11 eyes,ocular extirpation in nine eyes,one eye died one week after discharge,and one eye died two years after discharge. Analysis of the factors related to prognostic visual acuity in 45 eyes of 40 patients showed that there was no significant difference in prognostic visual acuity between the first six years and the last six years(X2=0.00,P=1.00).There was no significant difference in prognostic visual acuity among patients with different time intervals(X2=0.180,P=0.671).There was no significant difference in prognosis visual acuity between patients with basic disease and patients with diabetes(X2=1.624,P=0.202).There was a significant difference in prognostic visual acuity between patients with positive culture of pathogenic bacteria and those with negative culture of pathogenic bacteria or those without culture(X2=4.067,P=0.044).There was a significant difference in the prognostic visual acuity between IVI and PPV or PPV+IVI under different eye surgery methods(X2=5.625,P=0.018).There was no significant difference in prognostic visual acuity between PPV+IVI and PPV patients with different ocular treatment modality(P=0.665).After PPV or PPV+IVI treatment,there was no significant difference in prognostic visual acuity between patients treated with or without vitreous silicone oil filling(P=0.618),and patients treated with vitreous silicone oil removal(P=1.0).Prognostic visual acuity was significantly different in patients with or without complications(X2=5.472,P=0.034).There were significant differences in initial visual acuity(X2=14.778,P=0.000).The results of binary Logistic regression showed that the initial visual acuity of patients with visual acuity or above(P=0.040)and the use of PPV treatment(P=0.015)were the positive influencing factors for the prognosis of patients with EE.Conclusions:1.Endogenous endophthalmitis usually occurs in middle-aged and elderly men.Liver abscess and pulmonary infection are common primary infections.2.Initial visual acuity plays an important role in prognostic visual acuity,and there is a significant difference in prognostic visual acuity between patients with initial visual acuity without light perception and patients with initial visual acuity with light perception or above.Patients with initial lack of light perception have poor prognostic vision.3.The prognostic visual acuity of patients treated with vitrectomy and vitreous drug injection alone was significantly different.The prognosis of patients with vitreous injection is poor vision.4.There were significant differences in prognostic visual acuity between patients with and without complications,and patients with complications had poor prognostic visual acuity.In this study,patients with orbital cellulitis and secondary glaucoma had poor visual acuity.5.There was a significant correlation between the culture of pathogenic bacteria and the prognostic visual acuity of patients.Patients with negative or uncultured pathogenic bacteria had poor prognostic visual acuity.6.When other factors remained unchanged,initial visual acuity and visual acuity were positively correlated with vitrectomy for the prognosis of endogenous endophthalmitis. |
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