Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball

ObjectiveTo evaluate systemic inflammatory markers in cases of exogenous endophthalmitis caused by metal foreign bodies after penetrating eye injury and identify risk factors for poor control post-initial emergency surgery.MethodsTwenty-nine patients with exogenous endophthalmitis underwent emergenc...

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Main Authors: Donghai Wu, Yuan Lin, Huping Wu, Jinhong Cai
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1466530/full
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author Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
author_facet Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
author_sort Donghai Wu
collection DOAJ
description ObjectiveTo evaluate systemic inflammatory markers in cases of exogenous endophthalmitis caused by metal foreign bodies after penetrating eye injury and identify risk factors for poor control post-initial emergency surgery.MethodsTwenty-nine patients with exogenous endophthalmitis underwent emergency surgery with vitrectomy at Xiamen Eye Center (2016–2024). Evaluations included systemic inflammatory markers, microbiology, clinical presentation, treatment strategies, complications, prognostic factors, and visual outcomes. Correlation analysis was performed between blood test results and disease control after initial surgery.ResultsThe median patient age was 44.8 ± 16.9 years, with an average treatment delay of 6.1 ± 10.6 days. Males represented 86.2% (n = 25), and 41.3% (n = 12) had metallic intraocular foreign bodies, which correlated with faster symptom onset (p < 0.05) and higher inflammatory markers (WBC, neutrophils, basophils, CRP; p < 0.05). Primary lens extraction and intraoperative vancomycin did not significantly improve control (p > 0.05). Poor control post-vitrectomy was positively correlated with intraocular foreign bodies (R = 0.39, p < 0.05) and negatively with lymphocyte and monocyte counts (R = −0.43, p < 0.05; R = −0.46, p < 0.05). Early intervention within 2 h of symptom exacerbation reduced complication risk (AUC = 0.708, 95% CI: 0.547–0.838, p = 0.047).ConclusionMetallic intraocular foreign bodies provoke stronger systemic inflammatory responses, posing control challenges, especially in patients with lower immune resilience. Timely vitrectomy during initial emergency surgery is crucial for managing endophthalmitis.
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spelling doaj-art-905ae85ab5e84a74826a58e5ba9784d02024-12-09T04:26:41ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-12-011110.3389/fmed.2024.14665301466530Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeballDonghai Wu0Donghai Wu1Donghai Wu2Donghai Wu3Donghai Wu4Donghai Wu5Yuan Lin6Yuan Lin7Yuan Lin8Yuan Lin9Yuan Lin10Yuan Lin11Huping Wu12Huping Wu13Huping Wu14Huping Wu15Huping Wu16Huping Wu17Jinhong Cai18Jinhong Cai19Jinhong Cai20Jinhong Cai21Jinhong Cai22Jinhong Cai23Xiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, ChinaXiamen Clinical Research Center for Eye Diseases, Xiamen, ChinaXiamen Key Laboratory of Ophthalmology, Xiamen, ChinaFujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, ChinaXiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, ChinaTranslational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, ChinaXiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, ChinaXiamen Clinical Research Center for Eye Diseases, Xiamen, ChinaXiamen Key Laboratory of Ophthalmology, Xiamen, ChinaFujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, ChinaXiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, ChinaTranslational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, ChinaXiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, ChinaXiamen Clinical Research Center for Eye Diseases, Xiamen, ChinaXiamen Key Laboratory of Ophthalmology, Xiamen, ChinaFujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, ChinaXiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, ChinaTranslational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, ChinaXiamen Eye Center and Eye Institute of Xiamen University, School of Medicine, Xiamen, ChinaXiamen Clinical Research Center for Eye Diseases, Xiamen, ChinaXiamen Key Laboratory of Ophthalmology, Xiamen, ChinaFujian Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, ChinaXiamen Key Laboratory of Corneal & Ocular Surface Diseases, Xiamen, ChinaTranslational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, ChinaObjectiveTo evaluate systemic inflammatory markers in cases of exogenous endophthalmitis caused by metal foreign bodies after penetrating eye injury and identify risk factors for poor control post-initial emergency surgery.MethodsTwenty-nine patients with exogenous endophthalmitis underwent emergency surgery with vitrectomy at Xiamen Eye Center (2016–2024). Evaluations included systemic inflammatory markers, microbiology, clinical presentation, treatment strategies, complications, prognostic factors, and visual outcomes. Correlation analysis was performed between blood test results and disease control after initial surgery.ResultsThe median patient age was 44.8 ± 16.9 years, with an average treatment delay of 6.1 ± 10.6 days. Males represented 86.2% (n = 25), and 41.3% (n = 12) had metallic intraocular foreign bodies, which correlated with faster symptom onset (p < 0.05) and higher inflammatory markers (WBC, neutrophils, basophils, CRP; p < 0.05). Primary lens extraction and intraoperative vancomycin did not significantly improve control (p > 0.05). Poor control post-vitrectomy was positively correlated with intraocular foreign bodies (R = 0.39, p < 0.05) and negatively with lymphocyte and monocyte counts (R = −0.43, p < 0.05; R = −0.46, p < 0.05). Early intervention within 2 h of symptom exacerbation reduced complication risk (AUC = 0.708, 95% CI: 0.547–0.838, p = 0.047).ConclusionMetallic intraocular foreign bodies provoke stronger systemic inflammatory responses, posing control challenges, especially in patients with lower immune resilience. Timely vitrectomy during initial emergency surgery is crucial for managing endophthalmitis.https://www.frontiersin.org/articles/10.3389/fmed.2024.1466530/fullendophthalmitisocular traumaintraocular foreign bodyrisk factorinflammatory indicators
spellingShingle Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Donghai Wu
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Yuan Lin
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Huping Wu
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
Jinhong Cai
Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball
Frontiers in Medicine
endophthalmitis
ocular trauma
intraocular foreign body
risk factor
inflammatory indicators
title Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball
title_full Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball
title_fullStr Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball
title_full_unstemmed Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball
title_short Systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball
title_sort systematic inflammatory indicators and clinical management of exogenous endophthalmitis due to metal penetrating injury of eyeball
topic endophthalmitis
ocular trauma
intraocular foreign body
risk factor
inflammatory indicators
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1466530/full
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