Clinical Characteristics and Risk Factors for Evisceration in Trauma-Dominant Orbital Cellulitis: A 10-Year Review

Jiang, Zhaoxin; Zhongliu, Xueying; Ding, Xiaohu; Yang, Yao; Duan, Fang; Lin, Xiaofeng

doi:10.3389/fmed.2022.935022

Cited by 2 publications

(1 citation statement)

References 32 publications

(44 reference statements)

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“…Jiang et al described a predominance of Pseudomonas aeruginosa and Bacillus cereus species in trauma-related orbital cellulitis, which resulted in an evisceration rate of 40.5%. 31 Characterization of the impact of comorbid diabetes mellitus on orbital cellulitis has been limited to case reports, although it occurs at a rate of 0% to 14.7% in OA according to the literature. 32 The authors observed a significantly higher rate of diabetes (22.2%) in the OA cohort and a lower rate of 4.3% among SPA patients.…”

Section: Discussionmentioning

confidence: 99%

Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes

Gibbons,

Niknahad,

Bacorn

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To compare the clinical features, management, and outcomes between orbital cellulitis patients with subperiosteal abscess (SPA) and those with orbital abscess (OA). Methods: A retrospective study was conducted at a tertiary care center through medical record search to identify patients with orbital cellulitis from January 1, 2000 to December 31, 2022. Charts were screened for those with radiographic evidence of SPA or OA. Demographic data and presenting clinical features were compared between the 2 cohorts. Primary outcomes compared included rates of surgical intervention, reoperation, and readmission; and length of hospital stay and final vision. Results: A total of 189 patients, 162 with SPA and 27 with OA, met the criteria. The OA group (mean 46.5 ± 18.6 years) was older than the SPA group (mean 19.1 ± 21.4 years). Comorbid sinusitis was significantly more common in the SPA cohort (95.7% SPA; 70.4% OA; p < 0.001), while OA was more likely to occur with orbital trauma (29.6% vs. 8.0%; p = 0.003), implanted hardware (11.1% vs. 0.6%; p = 0.005), and comorbid diabetes (22.2% vs. 4.3%; p = 0.001). OA patients more often presented with a relative afferent pupillary defect (21.7% vs. 3.9%; p = 0.005), vision worse than 20 of 50 (42.3% vs. 16.2%; p = 0.005), and methicillin-resistant Staphylococcus aureus infection (20.8% vs. 5.8%; p = 0.036). OA was associated with a higher reoperation rate (47.8% vs. 21.3%; p = 0.019), readmission rate (18.5% vs. 5.6%, p = 0.047), and limited extraocular motility at follow-up (4.3% vs. 25%; p = 0.013); while mean length of hospital stay and final visual acuity were similar. Conclusion: OA may affect an older population with a divergent risk factor profile compared with SPA. OA may cause more severe functional impairment on presentation, warranting more aggressive management to achieve visual outcomes similar to SPA.

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Section: Discussionmentioning

confidence: 99%

Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes

Gibbons,

Niknahad,

Bacorn

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Endophthalmitis Caused by Bacillus cereus: Clinical Characteristics, Outcomes and Antibiotic Susceptibility

Zheng,

Lin,

Liao

et al. 2024

Antibiotics

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Bacillus cereus endophthalmitis is a severe vision-threatening disease. This study aimed to analyze the clinical characteristics, antibiotic susceptibility, and risk factors for poor final visual acuity (VA) and enucleation or evisceration (ENEV) outcomes of B. cereus endophthalmitis patients. We retrospectively reviewed 52 cases (52 eyes) of culture-proven B. cereus endophthalmitis at Zhongshan Ophthalmic Center from January 2013 to December 2023. The mean age of the patients was 38.1 ± 20.1 years, and males composed the majority (90.4%) of the sample size; laborers (32.7%) and farmers (19.2%) were the primary occupations of the patients. All cases were caused by ocular trauma. Forty-one of 51 eyes (80.4%) had a final VA worse than the ability to count fingers (CFs), and 15 of the 52 total eyes (28.8%) underwent ENEV. Binary logistic forward (LR) regression analysis demonstrated that red eye (odds ratio [OR], 13.13; 95% confidence interval [CI], 1.58–108.80; p = 0.017), eye pain (OR, 22.87; 95% CI, 1.00–522.72; p = 0.050), and corneal edema/ulcer (OR, 13.13; 95% CI, 1.58–108.80; p = 0.017) were significant risk factors for poor VA outcomes. Conjunctival sac purulent discharge (OR, 10.08; 95% CI, 2.11–48.12, p = 0.004) and white blood cell (WBC) count (OR, 1.35; 95% CI, 1.06–1.72, p = 0.016) were significant risk factors for ENEV outcomes. B. cereus showed susceptibility rates of 100.0% to vancomycin and ofloxacin; 98.0% to levofloxacin; 93.3% to ciprofloxacin; 87.5% to imipenem; and 78.9% to tobramycin. The susceptibility to azithromycin and clindamycin was 66.7% and 50.0%, respectively. In contrast, B. cereus was resistant to penicillin (susceptibility at 3.8%), cefuroxime (5.6%), and cefoxitin (37.1%).

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Clinical Characteristics and Risk Factors for Evisceration in Trauma-Dominant Orbital Cellulitis: A 10-Year Review

Cited by 2 publications

References 32 publications

Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes

Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes

Endophthalmitis Caused by Bacillus cereus: Clinical Characteristics, Outcomes and Antibiotic Susceptibility

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