Infectious endophthalmitis is a severe intraocular infection caused by bacteria, or less commonly by fungi. It can occur after penetrating eye procedures, trauma, or the spread of infection from contiguous structures or via emboli from distant organs. Because of the time-critical nature of the treatment, endophthalmitis is treated with the clinical diagnosis and modified by the microbiological report of the intraocular contents. The current strategy for managing endophthalmitis relies on pre-clinical literature, case series, and one large multi-center randomized clinical trial on post-cataract surgery endophthalmitis. Culture-susceptibility of the microorganisms from undiluted vitreous guides the definitive treatment in non-responsive cases. Strategies to reduce the incidence of endophthalmitis after penetrating eye procedures have been developed concurrently with refined means of treatment.

Despite these advances, outcomes remain poor for many patients. Although consensus articles have been published on managing endophthalmitis, treatment patterns vary, and controversies remain. These include (1) the use of newer methods for early and precise microbiological diagnosis; (2) the choice of intravitreal antibiotics; (3) the need for systemic therapy; (4) early and complete vitrectomy. Here, we review the current consensus and address controversies in diagnosing and managing endophthalmitis. This review is intended to familiarize physicians and ophthalmologists with different aspects of endophthalmitis management to make informed decisions.

感染性眼内炎是由细菌引起的严重眼内感染，较少见的是由真菌引起的。它可能发生在穿透性眼部手术、创伤或感染从邻近结构或通过远处器官的栓子扩散后。由于治疗的时间紧迫性，眼内炎需要根据临床诊断进行治疗，并根据眼内内容物的微生物学报告进行修改。目前治疗眼内炎的策略依赖于临床前文献、病例系列和一项关于白内障手术后眼内炎的大型多中心随机临床试验。未稀释玻璃体中微生物的培养敏感性指导无反应病例的确定性治疗。减少穿透眼手术后眼内炎发生率的策略已与完善的治疗手段同时制定。

尽管取得了这些进展，但许多患者的治疗效果仍然不佳。尽管已经发表了有关眼内炎治疗的共识文章，但治疗模式各不相同，并且仍然存在争议。这些包括（1）使用更新的方法进行早期和精确的微生物诊断；(2)玻璃体内抗生素的选择；(3)需要全身治疗；(4)早期、完整的玻璃体切除术。在这里，我们回顾当前的共识并解决眼内炎诊断和治疗方面的争议。本综述旨在让医生和眼科医生熟悉眼内炎管理的不同方面，以便做出明智的决定。