Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population

Zhu Li Yap,1,2 You Chuen Chin,1 Judy Yu-Fen Ku,1 Tat Keong Chan,1,2 Gillian Teh,1,2 Monisha Esther Nongpiur,2,3 Tin Aung,1,2 Shamira A Perera1–3 1Singapore National Eye Centre, Singapore; 2Singapore Eye Research Institute, Singapore; 3Duke NUS Graduate Medical School, Singapore Purpose:...

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Autores principales:	Yap ZL, Chin YC, Ku JYF, Chan TK, Teh G, Nongpiur ME, Aung T, Perera SA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	bleb related infections blebitis bleb related endophthalmitis Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/3b80ac703d0446c4b6a8b5844959da4b
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spelling	oai:doaj.org-article:3b80ac703d0446c4b6a8b5844959da4b2021-12-02T08:38:39ZBleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population1177-5483https://doaj.org/article/3b80ac703d0446c4b6a8b5844959da4b2016-11-01T00:00:00Zhttps://www.dovepress.com/bleb-related-infections-clinical-characteristics-risk-factors-and-outc-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Zhu Li Yap,1,2 You Chuen Chin,1 Judy Yu-Fen Ku,1 Tat Keong Chan,1,2 Gillian Teh,1,2 Monisha Esther Nongpiur,2,3 Tin Aung,1,2 Shamira A Perera1–3 1Singapore National Eye Centre, Singapore; 2Singapore Eye Research Institute, Singapore; 3Duke NUS Graduate Medical School, Singapore Purpose: Comparison of the demographic, ocular, systemic and microbiological characteristics of eyes with bleb related infection (BRI) and bleb related endophthalmitis (BRE). Methods: Retrospective chart review of patients with BRI from January 1996–July 2013. Identification done via the center’s longstanding endophthalmitis audit, BRI audit and laboratory database identifying all conjunctival swabs from blebs. Blebitis was defined as anterior segment inflammation with mucopurulent material in or around the bleb, with anterior chamber cells but no hypopyon. BRE was defined by the presence of hypopyon or vitreous inflammation. Results: Twenty-nine patients with blebitis and 10 with BRE were identified. Mean age of subjects (n=39) was 68.4 (±13.3) with a preponderance of men (74.4%) and Chinese ethnicity (74.4%). BRE patients were 10.7 years older than blebitis patients (P=0.026). 28 (71.8%) subjects had primary open angle glaucoma. The presenting intraocular pressure (IOP) dropped in blebitis but almost doubled in BRE (P=0.011) compared to average preinfective IOP. Two weeks after treatment, IOPs in both groups returned to close to preinfective levels. Subjects with blebitis more often had an avascular bleb (88.0%) while those with BRE trended toward a moderately vascular bleb (50%). The distribution of causative microorganisms between the groups was similar. Conclusion: Our study indicates that risk factors are similar in both groups even though the visual outcome and clinical course, in the form of IOP findings and bleb vascularity, can diverge significantly. The decreased IOP in blebitis subjects represents objective evidence of subclinical leaks or bleb sweating. Keywords: bleb related endophthalmitis, blebitis, post-trabeculectomyYap ZLChin YCKu JYFChan TKTeh GNongpiur MEAung TPerera SADove Medical Pressarticlebleb related infectionsblebitisbleb related endophthalmitisOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 10, Pp 2303-2309 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	bleb related infections blebitis bleb related endophthalmitis Ophthalmology RE1-994
spellingShingle	bleb related infections blebitis bleb related endophthalmitis Ophthalmology RE1-994 Yap ZL Chin YC Ku JYF Chan TK Teh G Nongpiur ME Aung T Perera SA Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population
description	Zhu Li Yap,1,2 You Chuen Chin,1 Judy Yu-Fen Ku,1 Tat Keong Chan,1,2 Gillian Teh,1,2 Monisha Esther Nongpiur,2,3 Tin Aung,1,2 Shamira A Perera1–3 1Singapore National Eye Centre, Singapore; 2Singapore Eye Research Institute, Singapore; 3Duke NUS Graduate Medical School, Singapore Purpose: Comparison of the demographic, ocular, systemic and microbiological characteristics of eyes with bleb related infection (BRI) and bleb related endophthalmitis (BRE). Methods: Retrospective chart review of patients with BRI from January 1996–July 2013. Identification done via the center’s longstanding endophthalmitis audit, BRI audit and laboratory database identifying all conjunctival swabs from blebs. Blebitis was defined as anterior segment inflammation with mucopurulent material in or around the bleb, with anterior chamber cells but no hypopyon. BRE was defined by the presence of hypopyon or vitreous inflammation. Results: Twenty-nine patients with blebitis and 10 with BRE were identified. Mean age of subjects (n=39) was 68.4 (±13.3) with a preponderance of men (74.4%) and Chinese ethnicity (74.4%). BRE patients were 10.7 years older than blebitis patients (P=0.026). 28 (71.8%) subjects had primary open angle glaucoma. The presenting intraocular pressure (IOP) dropped in blebitis but almost doubled in BRE (P=0.011) compared to average preinfective IOP. Two weeks after treatment, IOPs in both groups returned to close to preinfective levels. Subjects with blebitis more often had an avascular bleb (88.0%) while those with BRE trended toward a moderately vascular bleb (50%). The distribution of causative microorganisms between the groups was similar. Conclusion: Our study indicates that risk factors are similar in both groups even though the visual outcome and clinical course, in the form of IOP findings and bleb vascularity, can diverge significantly. The decreased IOP in blebitis subjects represents objective evidence of subclinical leaks or bleb sweating. Keywords: bleb related endophthalmitis, blebitis, post-trabeculectomy
format	article
author	Yap ZL Chin YC Ku JYF Chan TK Teh G Nongpiur ME Aung T Perera SA
author_facet	Yap ZL Chin YC Ku JYF Chan TK Teh G Nongpiur ME Aung T Perera SA
author_sort	Yap ZL
title	Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population
title_short	Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population
title_full	Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population
title_fullStr	Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population
title_full_unstemmed	Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population
title_sort	bleb related infections: clinical characteristics, risk factors, and outcomes in an asian population
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/3b80ac703d0446c4b6a8b5844959da4b
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_version_	1718398411728748544

Bleb related infections: clinical characteristics, risk factors, and outcomes in an Asian population

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