目的:分析肝脓肿致内源性眼内炎的临床表现与治疗效果。方法:对我院2005/2010年诊治的因肝脓肿致内源性眼内炎7例(9眼)患者进行回顾性分析。所有患者取血或玻璃体标本行微生物培养;4眼行玻璃体切割术,2眼因全身状态差行玻璃体注药术,3眼因眼内炎表现较轻仅应用广谱抗生素治疗。结果:其中2眼以眼内炎为首诊,经全身检查后发现患有肝脓肿;4眼伴有糖尿病,1眼伴有糖耐量异常。血或玻璃体标本微生物培养阳性6眼(67%),其中肺炎克雷伯菌3眼,大肠埃希菌1眼,白色念珠菌2眼。经药物或手术治疗后,5眼获得手动及以上视力,1眼存有光感,3眼失明。结论:肝脓肿致眼内炎是一种严重危害视功能的眼科急症,及早就医、及时诊断、及时抗感染治疗是控制感染的最有效方法。玻璃体切割术联合抗生素治疗,有助于保存患者的部分视力。

AIM:To analyze the clinical feature and treatment of endogenous endophthalmitis caused by liver abscess. METHODS: A total of 9 eyes (7 cases) with endogenous endophthalmitis caused by liver abscess in our hospital from 2005 to 2010 were analyzed retrospectively. Microorganism was cultivated with blood or vitreous in all patients.4 eyes were performed vitrectomy. 2 eyes were injected antibiotics in vitreous cavity. 3 eyes were only treated with antibiotics.RESULTS: Two cases (2 eyes) were diagnosed with endophthalmitis firstly, then found liver abscess; 4 eyes were with diabetes mellitus, and 1 eye with abnormal glucose tolerance. Cultivation of microorganism was positive in 6 eyes (67%), including Pneumonia cray-research, Candida albicans and Escherichia coli. 5 eyes had useful vision after treatment, 1 eye had light perception,3 eyes became blindness. CONCLUSION: As an ocular emergency, endogenous endophthalmitis caused by liver abscess can severely damage visual function. Timely consultation, early diagnosis, proper systemic and topical anti-infective and anti-inflammatory treatment are the most effective methods for controlling infection. Vitrectomy with intravitreal antibiotics plays an important role in preserving useful vision function in patients.