Chinese Journal of Ophthalmology and Otorhinolaryngology, Volume. 25, Issue 4, 311(2025)
Current status of quality control in diagnosis and treatment of traumatic infectious endophthalmitis
Traumatic infectious endophthalmitis (TIE) is a severe complication following open globe injuries, characterized by pathogen invasion leading to intraocular infection. Prognosis is influenced by injury characteristics (e.g., wound type, retained foreign bodies), pathogen virulence, and timeliness of intervention. Quality control is pivotal in reducing infection risks and improving outcomes, emphasizing diagnostic accuracy, standardized treatment, and multidisciplinary collaboration. High-risk populations include young adult males and children, with infection rates reaching 4%-16% post-injury. Key risk factors include corneal/limbal wounds (Zone I), delayed closure (>24 h), and non-metallic foreign bodies (e.g., wood). Diagnostic quality control focuses on standardized history-taking (environment, type of foreign body), symptom stratification (acute bacterial vs subacute fungal features), and multimodal testing. Metagenomic next-generation sequencing (mNGS) enhances pathogen detection sensitivity (88%), complementing traditional cultures. Treatment protocols prioritize intravitreal vancomycin (10 g/L) combined with ceftazidime (22.5 g/L) for bacterial infections, while voriconazole is preferred for fungal cases. Early vitrectomy with silicone oil tamponade is critical for severe infections, alongside retinal protection. Standardized quality control system has reduced blindness rates by 20%-40%. Future directions include AI-driven early diagnosis, rapid molecular testing in primary care, multicenter data sharing, and novel therapies to shift from reactive treatment to proactive prevention.
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XU Huan, SUN Zhongcui, HE Zhonghui, CHU Ruilin, WEN Wen, JIANG Rui, JIANG Chunhui. Current status of quality control in diagnosis and treatment of traumatic infectious endophthalmitis[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2025, 25(4): 311
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Received: May. 20, 2025
Accepted: Aug. 25, 2025
Published Online: Aug. 25, 2025
The Author Email: JIANG Chunhui (chhjiang70@163.com)