{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T04:33:16Z","timestamp":1684557196901},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T00:00:00Z","timestamp":1657238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund Endophthalmitiden stellen einen der schwerwiegendsten Notf\u00e4lle in der Ophthalmologie dar. Um deren Pr\u00e4valenz zu minimieren, ist eine m\u00f6glichst genaue Kenntnis ausl\u00f6sender\n          Faktoren von Bedeutung. Eine chirurgische Therapie mit gezielter, erregerspezifischer Medikation und ein intaktes Immunsystem sind die Basis f\u00fcr den Visuserhalt. Ferner stellt sich die\n          Frage, ob anhand zugrunde liegender Erkrankungen am Auge ein ung\u00fcnstiger Verlauf prognostiziert werden kann, sodass ein Vergleich zwischen Glaukom- (G) und Nichtglaukompatienten (NG) im\n          Hinblick auf urs\u00e4chliche Faktoren, Erreger, Therapie und Visusverlauf gezogen wurde. Da bei Glaukompatienten eine potenzielle Alteration des lokalen Immunsystems diskutiert wird, ist von\n          Interesse, ob sich die klinischen Verl\u00e4ufe einer Endophthalmitis von Nichtglaukompatienten unterscheiden.<\/jats:p><jats:p>\n          Patienten und Methoden Es handelt sich um eine retrospektive Analyse von 75 Augen (13 G, 62 NG), die in einem 5-Jahres-Zeitraum aufgrund einer Endophthalmitis an der Augenklinik des\n          Universit\u00e4tsklinikums Erlangen-N\u00fcrnberg behandelt wurden. Auszuwertende Parameter waren u.\u200aa. das klinische Bild, operative und medikament\u00f6se Behandlungen, das mikrobielle Spektrum und der\n          Visusverlauf bei Glaukom- sowie Nichtglaukompatienten.<\/jats:p><jats:p>\n          Ergebnisse Bei Erstvorstellung dominierte bei allen Patienten eine akute Visusverschlechterung (44%) mit Vorderkammerreiz (62,7%), Hypopyon (52%) und reduziertem (40%) oder fehlendem\n          (26,7%) Funduseinblick. Vorangehende intraokularchirurgische Eingriffe wurden bei insgesamt 53,3% beobachtet, insbesondere Kataraktoperationen. In beiden Gruppen konnten grampositive Kokken\n          als h\u00e4ufigster Erreger identifiziert werden (G: 23,1%; NG: 38,7%), wohingegen seltene Keime nur bei Glaukompatienten vorkamen. Bei 76% aller Patienten wurde eine Pars-plana-Vitrektomie\n          durchgef\u00fchrt, eine Enukleation bei 20%, Letzteres signifikant h\u00e4ufiger bei Glaukompatienten (p\u2009=\u20090,01). Postoperativ konnte eine signifikante Visusverbesserung bei Nichtglaukompatienten\n          erzielt werden (p\u2009&lt;\u20090,001); im Direktvergleich stellte sich ein schlechteres visuelles Outcome bei glaukomat\u00f6s vorerkrankten Augen dar.<\/jats:p><jats:p>\n          Schlussfolgerung Stellt die Endophthalmitis eine sehr seltene Erkrankung dar, ist eine fr\u00fchzeitige Diagnosestellung und Behandlung dennoch f\u00fcr die Prognose entscheidend. In der\n          vorliegenden Kohorte zeigt sich ein schlechterer Endvisus bei Glaukompatienten als bei Nichtglaukompatienten.<\/jats:p>","DOI":"10.1055\/a-1895-2720","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T22:45:28Z","timestamp":1657320328000},"page":"689-696","source":"Crossref","is-referenced-by-count":0,"title":["Endophthalmitis: Ursachen, Erreger, Therapie und Visusverlauf mit Fokus auf Glaukompatienten"],"prefix":"10.1055","volume":"240","author":[{"given":"Julia","family":"Vorbeck","sequence":"additional","affiliation":[{"name":"Augenklinik, Universit\u00e4tsklinikum Erlangen-N\u00fcrnberg, Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina","family":"Hohberger","sequence":"additional","affiliation":[{"name":"Augenklinik, Universit\u00e4tsklinikum Erlangen-N\u00fcrnberg, Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Bergua","sequence":"additional","affiliation":[{"name":"Augenklinik, Universit\u00e4tsklinikum Erlangen-N\u00fcrnberg, Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3341\/kjo.2017.0036","article-title":"Endophthalmitis","volume":"31","author":"S J Sheu","year":"2017","journal-title":"Korean J Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1097\/IAE.0b013e3180323f96","article-title":"Endophthalmitis: a review of current evaluation and\u00a0management","volume":"27","author":"C A Lemley","year":"2007","journal-title":"Retina"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1586\/eop.10.52","article-title":"Severe bacterial endophthalmitis: towards improving clinical outcomes","volume":"5","author":"B D Novosad","year":"2010","journal-title":"Expert Rev Ophthalmol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.disamonth.2016.09.005","article-title":"Endophthalmitis","volume":"63","author":"C Cunningham","year":"2017","journal-title":"Dis Mon"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1111\/1469-0691.12118","article-title":"Endophthalmitis","volume":"19","author":"M L Durand","year":"2013","journal-title":"Clin Microbiol Infect"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1128\/cmr.15.1.111-124.2002","article-title":"Bacterial endophthalmitis: epidemiology, therapeutics, and bacterium-host interactions","volume":"15","author":"M C Callegan","year":"2002","journal-title":"Clin Microbiol Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"121","DOI":"10.2147\/opth.s6461","article-title":"Endophthalmitis: pathogenesis, clinical presentation, management, and perspectives","volume":"4","author":"M Kernt","year":"2010","journal-title":"Clin Ophthalmol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1001\/archopht.1995.01100120009001","article-title":"Results of the endophthalmitis vitrectomy study. 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