Abstract
Purpose :
To investigate epidemiologic and clinical characteristics, visual outcomes and prognostic factors of endophthalmitis with intraocular foreign body (IOFB) in Children.
Methods :
Information from 116 eyes with endophthalmitis was selected from 484 eyes of children (age ranged from 1 to 17) with IOFB in Zhongshan Ophthalmic Center over a 13-year period. The clinical characteristics and endophthalmitis spectrum were described. Factors affecting development of endophthalmitis were analyzed statistically. Ordinal logistic regression modelling was used to analyse the relationship between final visual outcome and multiple predictor variables.
Results :
Endophthalmitis represented 24% of all pediatric IOFBs patients. The mean age at presentation was 8.74 ± 4.39 years. Explosions (29.3%), plant injury (19.6%), pencil-tip injury (8.6%) were the most common cause of injury. Non-metal foreign bodies account for 78.4% of all IOFBs in patients with endophthalmitis. Gram-positive bacteria were isolated in 65.4% (n=17) of the culture positive cases. Bacillus (25.9%), coagulase negative staphylococcus (14.8%) and Enterobacteriaceae (11.1%) were the common causative organism. Metal IOFBs (OR=0.334, p=0.001), hematophthalmia (OR=0.105, p<0.001), and iris or choroid prolapses (OR=0.217, p<0.001) were the independent protective factors in the development of endophthalmitis, while zone II injury (OR=3.882, p<0.001) and traumatic cataract (OR=3.795, p=0.006) were risk factors. Compared to the best preoperative visual acuity, NLP and LP to 4/200 level showed an approximately 10000-fold (OR = 10097, p < 0.01) and 44-fold (OR = 43.82, p = 0.01) increase in the odds of being in a poorer visual outcome category.
Conclusions :
Endophthalmitis among children with IOFBs are more prevalent in school-age boys. Metal IOFB, iris or choroid prolapse, and hematophthalmia are protective factors in the development of endophthalmitis. Worse presenting VA predicts worse visual outcome.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.