Pediatric endophthalmitis. A 10-year consecutive series.

PURPOSE

To report the etiology, culture results, management techniques, and visual outcomes for pediatric endophthalmitis at Emory University for the past 10 years.

METHODS

Retrospective chart review based on a computer generated database of all cases of endophthalmitis occurring in patients younger than 18 years from 1995 to 2005.

RESULTS

Sixteen cases of pediatric endophthalmitis were identified. Ocular trauma and previous ocular surgery were the most common etiologies, accounting for 44% and 38% of cases respectively. Nine cases (56%) had positive vitreous cultures. Sixty-six percent of cases with positive vitreous cultures involved Gram-positive species. All patients were treated with intravitreal antibiotics. Primary vitrectomy was performed in nine cases. Subsequent to the intraocular infection, 6 eyes (38%) developed retinal detachments. At last follow-up, visual acuity of 20/400 or better was obtained in only 6 eyes (38%).

CONCLUSIONS

Pediatric endophthalmitis in this series most commonly resulted from penetrating ocular trauma or from ocular surgery. Retinal detachment commonly occurred as a complication. Despite aggressive management with antibiotics and in many cases vitrectomy, visual outcomes were poor in this series.