下方玻璃体腔注射后眼内炎高发病率研究

Inferior intravitreal injection site associated with a higher incidence of post-injection endophthalmitis

摘要:

目的：探讨下方玻璃体腔注射比上方注射出现注射后眼内炎的几率是否更高。下方小梁切除术滤过泡眼内炎的发病率高于上方小梁切除术滤过泡，有可能是因为细菌聚集在下方的泪湖。

方法：经过广泛实践过的眼内炎病例数据库验证，发现在2a的研究期间内，有5例眼内炎病例。同时，为了评估注射部位对发病率的影响，对治疗过的909例1 121眼共计8672次注射进行了回顾性调查。

结果：5眼出现感染性眼内炎，80%的眼内炎病例均是下方注射，尽管所选病例中84.6%是位于上方注射。与感染有关的下方注射部位的危险比是(OR)22.1(P=0.006)。

结论：玻璃体腔注射后感染眼内炎的几率很小，仅为0.025%。避免在偏下象限进行玻璃体腔注射可能会进一步减小眼内炎的发病率。

Abstract:

AIM:To determine whether inferior injections had a higher incidence of post-injection endophthalmitis than superior injections. The incidence of endophthalmitis is higher for inferior than superior trabeculectomy filtering blebs, possibly due to bacteria pooling in the inferior tear lake.

METHODS: A practice-wide database of endophthalmitis cases identified 5 occurring during the two-year study period. A retrospective review of 8 672 injections in 1 121 eyes of 909 patients treated during the same two-year study period was performed in order to assess the injection site location.

RESULTS: Five eyes developed presumed infectious endophthalmitis. Eighty percent of endophthalmitis cases were injected inferiorly, even though 84.6% of the total cohort was injected superiorly. The odds ratio of infection associated with inferior injection location is 22.1(P=0.006).

CONCLUSION:Endophthalmitis after intravitreal injection is rare, occurring in only 0.025% of injections overall. Avoiding intravitreal injections in the inferior quadrants may further reduce the rate of endophthalmitis.