Incidence and Risk Factors of Intraocular Foreign Body-Related Endophthalmitis in Southern China

Duan, Fang; Yuan, Zhihang; Liao, Jinli; Zheng, Yongxin; Yang, Yao; Lin, Xiaofeng

doi:10.1155/2018/8959108

Cited by 21 publications

(21 citation statements)

References 23 publications

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“…It is controversial whether the material of the IOFB can increase the risk of endophthalmitis. Endophthalmitis resulting from wood can range from 26.9% to 55% of IOFB cases, 15 -17 much higher than the incidence with metal (up to 16.3%). Other reports state there is no significant difference based on material type.…”

Section: Discussionmentioning

confidence: 95%

Wood-Related Open-Globe Injuries

Pfister

Bohnak

Patel

2020

Journal of VitreoRetinal Diseases

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Purpose: This work evaluates the clinical characteristics, visual outcomes, and complications of patients treated for open-globe injuries (OGIs) caused by wooden objects. Methods: A retrospective review of medical records was conducted on patients presenting to a tertiary trauma center with an OGI between January 2005 and December 2017. Medical records were isolated for wounds caused by wooden objects. Patient demographics were recorded, with presenting visual acuity (VA), physical examination findings, and wound characteristics. After primary globe repair, secondary complications, need for additional surgery, and visual outcomes were noted until final examination. Main outcome measures were final VA and secondary complications. The Ocular Trauma Score (OTS) was computed and assessed for clinical relevance related to visual outcomes. Results: Thirty-two patients met the inclusion criteria, with 15 (47%) being injured by plant material. Thirty of the patients were men (94%). A large portion of patients presented with hand motion or worse vision (48%), and there were high rates of hyphema (59%), vitreous hemorrhage (31%), retinal detachment (28%), and endophthalmitis (9%). Two patients eventually required enucleation. At last follow-up, 19 patients achieved 20/100 VA or better (59.4%), which correlated with their OTS ( P < .001). Conclusions: Despite the high clinical severity of wood OGIs, the potential for visual recovery remains high. The OTS appropriately assesses the severity of injuries and the likely prognosis in this cohort of patients.

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Section: Discussionmentioning

confidence: 95%

Wood-Related Open-Globe Injuries

Pfister

Bohnak

Patel

2020

Journal of VitreoRetinal Diseases

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“…Studies have found that the incidence of PTE without IOFB is between 3.1% and 30%; however, this figure may be as high as 60% in cases that involve a foreign body. 5,6,[33][34][35][36][37][38] Researchers have further stratified IOFBs by location and have found that posterior foreign bodies pose a greater risk for developing endophthalmitis than do anterior foreign bodies. 6,37 A limitation of the NIS Database is that it does not specify the intraocular location site of the IOFB; for this reason, we could not differentiate between anterior and posterior foreign bodies.…”

Section: Discussionmentioning

confidence: 99%

“…6 Duan et al found that cases with organicmaterial IOFBs (eg, twig injury) had the highest risk of developing endophthalmitis, whereas glass and plastic IOFBs had the lowest risk. 38 Researchers also theorize that high-velocity foreign bodies (ordnance-related and fireworks accidents) may be associated with a decreased risk of developing infection because the high-speed projectiles can heat up through increased air resistance and can become self-sterilized before impact. 6 In their study of 79 US military soldiers who experienced combat-related OGI, Colyer and colleagues found that no eyes developed endophthalmitis even with delayed IOFB removal.…”

Section: Discussionmentioning

confidence: 99%

“…6 In their study of 79 US military soldiers who experienced combat-related OGI, Colyer and colleagues found that no eyes developed endophthalmitis even with delayed IOFB removal. 35 Although most clinicians advocate prompt removal of the IOFB to decrease the risk of developing infection, 6,[36][37][38] delayed IOFB removal may not increase the risk of PTE. 35 Our data also found a significant positive association of corneal ulcers and keratitis with PTE.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Post–Open-Globe Injury Endophthalmitis

Uppuluri

Zarbin

Bhagat

2020

Journal of VitreoRetinal Diseases

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Purpose: The objective of our project is to use the National Inpatient Sample Database to identify risk factors for endophthalmitis in cases of open-globe injury (OGI). Methods: This is a cross-sectional observational study of 48 627 cases of OGI from the National Inpatient Sample Database. We performed regression analysis using IBM SPSS Statistics 23. Codes from the International Classification of Disease, Ninth Revision were used to identify ocular findings and conditions. Variables with P values less than .05 on univariate analysis were included in the multivariable regression model; Bonferroni correction was applied to these results. Results: Of the 48 627 cases of OGI, 37 440 (77.0%) occurred in the adult group (21 years and older). Overall, 1018 (2.1%) cases developed posttraumatic endophthalmitis, with 74.5% cases in the adult group. Endophthalmitis developed in 293 (4.5%) eyes with an intraocular foreign body (IOFB). Results of binary logistic regression showed the clinical findings of traumatic cataracts, hypopyon, vitreous inflammation, corneal ulcers, or IOFBs were associated with an increased risk of developing endophthalmitis after OGI. Conversely, orbital fractures, rupture-type injuries, and intraocular tissue prolapse were associated with a decreased likelihood of being diagnosed with endophthalmitis. Conclusions: Endophthalmitis developed in 2.4% of pediatric OGIs and 2.0% of adult OGIs. Traumatic cataract, hypopyon, vitreous inflammation, corneal ulcer, keratitis, retinal detachment, IOFB, and diabetes increased the risk of post-open-globe endophthalmitis.

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“…IOFB injuries were reported in 43% of posttraumatic endophthalmitis cases [6]. A number of studies showed that the specific characteristics of the IOFB, microorganisms, and time between the injury and treatment were associated with an increased risk of endophthalmitis following penetrating trauma [7][8][9]. An understanding of the spectrum of pathogens and their antibiotic susceptibilities is essential to guide first-line empirical treatment.…”

Section: Introductionmentioning

confidence: 99%

Microbiological Isolates and Antibiotic Susceptibilities in Cases of Posttraumatic Endophthalmitis: A 15-Year Review

Liu

Wang

et al. 2020

Journal of Ophthalmology

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Purpose. The objective of this study was to evaluate the microbiological spectrum and antibiotic susceptibilities of isolates in posttraumatic endophthalmitis over a 15-year period. Methods. A retrospective study of 3,163 posttraumatic endophthalmitis cases was conducted between July 2004 and July 2019. The outcome measures included the microbiological spectrum and antibiotic susceptibilities. Chi-squared tests were conducted to detect trends in changes in antibiotic sensitivity over the 15-year period. P values of <0.05 were considered statistically significant. Results. Of the 3,163 cases of posttraumatic endophthalmitis, 1,003 culture-positive isolates were identified. Among these, there were 848 (84.5%) Gram-positive isolates, 109 (10.9%) Gram-negative isolates, and 46 (4.6%) fungal isolates. The most common isolates were Staphylococcal species. There was a significant increase in the percentage of fungal isolates over the 15-year period (P=0.02). Gram-positive organisms showed the greatest level of susceptibility to vancomycin (99.6%). The susceptibilities of the 109 Gram-negative isolated organisms were as follows: levofloxacin (95.8%), meropenem (95.7%), ciprofloxacin (93.5%), tobramycin (90.8%), imipenem (88.9%), trimethoprim-sulfamethoxazole (TMP-SMX) (87.7%), ertapenem (80%), and ceftazidime (79.1%). The susceptibility of Gram-positive organisms to several antibiotics, including levofloxacin (P=0.004), ciprofloxacin (P<0.001), and chloramphenicol (P=0.001) decreased over time, whereas the susceptibility to TMP-SMX increased over time (P<0.001). The susceptibility of Gram-negative bacilli to ceftazidime decreased over time (P=0.03). Conclusions. Over the 15-year study period, most isolates were Gram-positive cocci, especially coagulase-negative staphylococci (CNS). Vancomycin seemed to be the most effective antibiotic for Gram-positive bacteria. Gram-negative bacteria appeared to be most susceptible to fluoroquinolones. A number of antibiotics showed an increasing trend of microbial resistance.

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Incidence and Risk Factors of Intraocular Foreign Body-Related Endophthalmitis in Southern China

Cited by 21 publications

References 23 publications

Wood-Related Open-Globe Injuries

Wood-Related Open-Globe Injuries

Risk Factors for Post–Open-Globe Injury Endophthalmitis

Microbiological Isolates and Antibiotic Susceptibilities in Cases of Posttraumatic Endophthalmitis: A 15-Year Review

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