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Abdulrahman AL-SAEDI, Ahmed Abu El-Asrar, Saba Abdulmohsen Alreshaid; Visual outcomes and microbiological spectrum of pediatric exogenous endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6382.
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© ARVO (1962-2015); The Authors (2016-present)
Endophthalmitis in pediatric age group, although uncommon, but can lead to devastating complications. Literature on pediatric endophthalmitis is scarce. We investigate the etiology, microbiological profile, management and outcomes of pediatric endophthalmitis over two time periods.
Retrospective chart review of exogenous endophthalmitis cases (i.e. secondary to ocular trauma or surgery) in patients aged 18 years or younger and managed at 2 tertiary hospitals in Riyadh, Saudi Arabia from 2005 to 2013 (Group B) was done. A comparison was made to a previously reported case series from 1980 to 2004 (Group A) from the same two hospitals.
Between 2005 and 2013, 54 cases were identified. Endophthalmitis was secondary to ocular trauma in 45 (83.3%) cases and followed ocular surgery in 9 (16.7%) cases. Post-operative endophthalmitis was most commonly secondary to glaucoma-filtering procedures; in 4 (44.4%) cases. Twenty-seven (50%) cases were culture-positive and gram-positive organisms accounted for 77.8% of the total 36 isolated organisms. Streptococcus species were the most common isolates and accounted for 55.6% of the total isolates. The mean follow up was 46.5 ± 34.6 months (range, 1-108 months). Visual acuity at last follow up visit was 20/200 or better in 16 (29.6%) cases, counting fingers in 6 (11.1%) cases, hand motion to light perception in 11 (20.4%) cases and no light perception in 21 (38.9%) cases including 6 (11.1%) cases that had been enucleated or eviscerated. Patients in whom intravitreal dexamethasone was used achieved final visual acuity of 20/200 or better in 14 (53.8%) cases compared to two (7.1%) cases in whom intravitreal dexamethasone was not used (p <0.001). Type of endophthalmitis, positive culture and primary vitrectomy were not found to be significant in predicting the final visual outcome in this series. The etiology, microbiological spectrum and visual outcomes were not significantly different among the two periods.
Pediatric endophthalmitis was commonly secondary to ocular trauma and glaucoma-filtering procedures. No change in the trends of pediatric exogenous endophthalmitis was noted among the two periods. The microbiological profile among the two periods was similar and Streptococcus species were the most common isolates. Visual prognosis was poor and the use of intravitreal dexamethasone may improve the visual outcome.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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