摘要:

Endophthalmitis following open-globe injuries is caused by a specific range of microorganisms, of whichBacillus sp. and coagulase-negativeStaphylococcusare the most frequent. Risk factors include the presence of an intraocular foreign body, injury inflicted by organic material, delay in surgery, and the type of wound involved. Despite important advances in medical and surgical management, this type of endophthalmitis continues to pose a poor prognosis. In this sense, we consider prevention to be the best approach. We report our protocols for the prevention and treatment of endophthalmitis following open-globe injuries, based on recent experimental studies on the ocular pharmacokinetics of antibiotics and on multi center studies of the treatment of endophthalmitis.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Endogenous fungal endophthalmitis may present in a debilitated or otherwise healthy host, may be increasing in prevalence, and is most commonly caused byCandida albicans.Recognizing the potential for complications with systemic amphotericin B use, recent investigators have developed several newer principles governing the treatment of such cases. For cases of simple choroiditis or very minimal endophthalmitis (ie, vitritis), systemic treatment with oral fluconazole may be effective; however, if vitritis symptoms persist or progress, vitrectomy allows for better clearing of the organism. Intravitreal amphotericin B in conjunction with vitrectomy has been advocated by many. The most recent series have shown that an extended course of oral fluconazole following vitrectomy without intravitreal amphotericin B affects resolution of infection in the vast majority of patients. Final visual acuity outcomes depend most on the site of initial choroiditis. If the macula is spared and preretinal membranes can be effectively removed, visual acuity results can be exceedingly good.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Diabetic macular edema represents an important cause of visual loss in patients with diabetes. Although the pathophysiology of diabetic macular edema is unknown, various demographic, metabolic, and systemic factors have been implicated. More recently, the role of the posterior vitreomacular relationship has been evaluated, and studies suggest that posterior vitreous separation confers a protective effect on the development of diabetic macular edema. Furthermore, vitreomacular separation occurring in eyes with diabetic macular edema may facilitate spontaneous resolution of the edema and improvement in visual acuity. In a subset of patients, diffuse diabetic macular edema can result from a taut and condensed posterior hyaloid and often responds poorly to focal or grid-pattern laser photocoagulation. Previous studies have reported favorable results following vitrectomy and peeling of the posterior hyaloid in such cases.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID