First Author: O.Zborovska UKRAINE
Co Author(s): N. Pasyechnikova O. Dorokhova D. Elena 0 0 0 0 0 0 0 0 0
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To develop the endophthalmitis severity classification based on different clinical sings influenced its outcome. To increase the effectiveness of endophthalmitis treatment by using in complex therapy the antimicrobial photodynamic chemotherapy (APDT) with 0,1% methylene blue and laser radiation with wave length 630-670 nm.
The Filatov Institute of Eye Diseases and Tissue Therapy, NAMS Ukraine, Ukraine, Odessa.
We studied 101 case histories of patients with endophthalmitis (2001 – 2011 years), and then create database. Different clinical signs were formalized in the form of binary variables. We found out 3 categories of endophthalmitis outcome: vision save, eyeball save, enucleation. We calculated OR to quantify the impact of risk factors on the outcome of the treatment. We elaborated severity scoring assessment based on calculated OR. The main group (39 patients) was treated with APDT in complex therapy. The control group consisted of 101 patients, they were treated only with standard therapy. All patients were divided into three groups by severity of endophalmitis, using scoring scale.
We identified three severity eye status based on integral evaluation of variety clinical signs by using scoring scale. 1 - up to 10,7 units; 2 – up to 16,5 units; 3 – more 17 units. Clinical signs “vitreous are not visualize” OR=28,5; “cornea lysis” OR=15,2; “anterior chamber absence” OR=8,4; “iris are not visualize” OR=11,9; “lens are not visualize” OR=10,6 are associated with enucleation significantly. There was no difference in the outcome of endophthalmitis in patients with first severity group (by scoring scale). In the second severity group 81,3% patients, who had got APDT, saved vision. In control group only 38,2% patients saved vision. In the third severity group in main group 66,7% patients saved vision, and in control group only 31,3% patients saved vision. Enucleation was made in 2 patients from main group, and 7 patients from control group.
We developed endophthalmitis classification, that takes into consideration eye status severity and helps to predict outcome. We applied into practice of endophthalmitis treatment APDT with methylene blue and laser radiation (wave length 630-670 nm). It leads to better functional result in patients with second and third endophtalmitis severity according to scoring scale.