内源性真菌性眼内炎的临床特征及手术治疗

Clinical characteristics and surgical treatment of endogenous fungal endophthalmitis

目的 分析内源性真菌性眼内炎的临床特征及手术治疗效果.方法 回顾性研究,分析6例（7眼）的临床特点和手术效果.结果 共6例（7眼）,均无眼外伤或内眼手术史,无全身侵入性操作史.本病的特点是易发生于老年、女性、糖尿病者、长期使用糖皮质激素者.早期临床表现与一般葡萄膜炎相似.3例（3眼）行眼球摘除术,1例（双眼患者）死亡,1例（1眼）行玻璃体切除术加玻璃体腔注射抗真菌药物,保存了部分视功能,1例失访.结论 内源性真菌性眼内炎根据病史、临床表现及实验室检查可以确诊并且与一般葡萄膜炎相鉴别,早期施行玻璃体切除加玻璃体腔抗真菌药物注射可以保存部分视功能.

Objective To analyze the clinical characteristic,diagnosis and surgical treatment results of endogenous fungal endophthalmitis.Methods A retrospective study of 6 cases （7 eyes） was done.The susceptible factors,pathological feature and surgical treatment were analyzed.Results The seven eyes of 6 cases had no eye injuries,no eye surgery,no systemic invasive operation history before were involved.Endogenous fungal endophthalmitis susceptible factors included elder,women,poor diabetes control and long-term use of glucocorticoid.Early clinical manifestation was not easy to distinguish from other uveitis.The treatment results included 3 cases （3 eyes） of enucleation of eyeball,1 case （2 eyes） died,1 case （1 eye） treated with pars plana vitrectomy and injection of antifungal medicine,and part of the visual function was saved.1 case was lost to follow-up.Conclusion Endogenous fungal endophthalmitis can be distinguished with other uveitis by history,clinical manifestation and laboratory examination.Early implementation of pars plana vitrectomy and injection of antifungal medicine can save part of visual function.