A multicentre prospective study of post-traumatic endophthalmitis. - Archive ouverte HAL
Article Dans Une Revue Acta Ophthalmologica Année : 2013

A multicentre prospective study of post-traumatic endophthalmitis.

Résumé

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 ± 2.5 days). 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.

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Organes des sens

Dates et versions

hal-00863654 , version 1 (19-09-2013)

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Pierre-Loïc Cornut, El Bichara Youssef, Alain Bron, Gilles Thuret, Philippe Gain, et al.. A multicentre prospective study of post-traumatic endophthalmitis.. Acta Ophthalmologica, 2013, 91 (5), pp.475-82. ⟨10.1111/j.1755-3768.2011.02349.x⟩. ⟨hal-00863654⟩
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