First Author: P.Suarez CHILE
Co Author(s): R. Manriquez R. Moya 0 0 0 0 0 0 0 0 0
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To report the inicidence, etiology, culture results, management techniques, and visual outcomes of paediatric post-traumatic endophthalmitis.
Ocular Trauma Unit (OTU), Hospital Salvador. Santiago, Chile
Retrospective analysis of paediatric patients (age 16 or less) who presented with open-globe injuries associated with endophthalmitis at a tertiary referral centre between 1st January 2010 and 31st December 2013. Clinical details were recorded to include type of ocular trauma, primary diagnosis, time between trauma and primary surgery, visual acuity at presentation and after treatment, systemic and ocular co-morbilities, culture results, type of antibiotic, type of surgery and complications related to the initial trauma or treatment.
Four cases of paediatric endophthalmitis were identified. All patients were males. The mean age of presentation was 10.2 years (5-17 years). Two (50%) children presented on the day of injury, one three days after injury and one, nine days after the initial trauma. The location of the would at initial presentation were two corneal, one scleral, and one corneo scleral. There was one intraocular foreign body (IOFB) placed close to the optic discin the vitreous cavity. One case (25%) had positive vitreous culture, Gram negative (E. coli and E. faecalis). All patients were treated with both, intravitreal and systemic antibiotics (intravenous). Three cases (75%) underwenrt pars plana vitrectomy (PPV) and all this cases developed retinal detachment. One case developed a re-detachment with good anatomical result after second PPV. After a mean follow-up of 8.5 months (2-18 months) visual acuity of 20/400 at last follow-up was present in one eye (25%). Three patients developed phtisis bulbi.
Endophthalmitis associated with open-globe injuries in paediatric population represents a clinical challenge both in diagnosis and management. The incidence of endophthalmitis can be reduced by prompt referral of trauma cases. Despite aggressive management with intravitreal antibiotics and in many cases vitrectomy, visual outcomes were poor in this series.