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Macular Infarction after Treatment of Endophthalmitis
眼內炎治療後併發黃斑部壞死：六病例報告
摘要
感染性眼內炎最常使用的治療方式之一是經由玻璃體內注射抗生素，目前普遍使用的是vancomycin加上aminoglycoside，但是，aminoglycoside對視網膜具有毒性，甚至有文獻報告產生黃斑部壞死的病例。本篇報告六個感染性眼內炎在經過玻璃體內注射amikacin或低劑量gentamicin的治療後，發生黃斑部壞死的病例。我們建議，應考慮使用對革蘭氏陰性菌的感染具同等療效，且安全劑量範圍較寬的ceftazidime，取代aminoglycoside，來治療感染性的眼內炎。
關鍵字
無資料並列摘要
Intravitreous injection with combination of vancomycin and aminoglycoside antibiotic is widely used for the treatment of endophthalmitis. Unfortunately, macular infarction was reported as a toxic sequela of aminoglycosides, including gentamicin as well as amikacin which was previously thought to be safe. Retrospective review of 78 cases of endophthalmitis on the files of our department from November 1990 to June 1995 revealed that 69 cases had received intravitreous injection of amikacin or low dose gentamicin. Of these, macular infarction was found in six cases and was implicated in severe visual loss after successful arrest of infectious endophthalmitis. Aminoglycoside-substituting ceftazidime should be considered as a safe alternative.
延伸閱讀
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