Venkatesh Ramesh, Dave Abhishek Prachi, Gurav Prachi, Agrawal Manisha
Dr. Shroff 's Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, Delhi.
Nepal J Ophthalmol. 2019 Jan;11(21):55-63. doi: 10.3126/nepjoph.v11i1.25419.
To study the clinico-microbiological profile and evaluate the functional and anatomical outcomes of pediatric post-traumatic endophthalmitis (PPTE).
This was a retrospective interventional case series. All medical case records of patients diagnosed with PPTE over a 5-year period from January 2011 to December2015 were reviewed. Data recorded was: age, sex, type of trauma, mode of injury, interval between trauma and presentation, treatment, follow-up duration and final functional and anatomical outcomes.
Forty-one eyes of 41 patients diagnosed with PPTE met the inclusion criteria. There were 26 boys and 15 girls. The mean age at the time of presentation was 7.34 years (1month -16years). The median interval between trauma and presentation was 3 days (mean = 13.71 days; 1-240 days). The average follow-up period was 292.24 days (median 150 days; 30 1440 days). Injury with wooden stick (20,50%) was the most common mode of injury. Culture positivity was noted in 25(61%) cases. Staphylococcusaureus was the most common organisms identified on culture. Univariate analysis of in dependent variables was done using the Chi-square test showed patients with positive culture for gram-positive organisms had better anatomical (p=0.038) and functional outcomes (p=0.043). 35(85%) patients underwent vitrectomy along with intraocular antibiotics. Optimal anatomical and functional outcomes were noted in 23(56.1%) and12(29.3%) respectively.
PPTE carries a significantly poor prognosis in terms of ocular integrity and visual function. PPTE is common in boys and often caused by vegetative matter. Staphylococcus aureus is the most common organism seen in PPTE. Early presentation following trauma and identification of gram-positive organisms have a better prognosis.
研究儿童创伤性眼内炎（PPTE）的临床微生物学特征，并评估其功能和解剖学结局。
这是一项回顾性干预性病例系列研究。回顾了2011年1月至2015年12月这5年间所有诊断为PPTE的患者的医疗病例记录。记录的数据包括：年龄、性别、创伤类型、损伤方式、创伤与就诊间隔时间、治疗方法、随访时间以及最终的功能和解剖学结局。
41例诊断为PPTE的患者的41只眼符合纳入标准。其中男孩26例，女孩15例。就诊时的平均年龄为7.34岁（1个月至16岁）。创伤与就诊的中位间隔时间为3天（平均 = 13.71天；1至240天）。平均随访期为292.24天（中位值150天；30至1440天）。木棍致伤（20例，50%）是最常见的损伤方式。25例（61%）病例培养呈阳性。金黄色葡萄球菌是培养中最常见的病原体。使用卡方检验对自变量进行单因素分析显示，革兰氏阳性菌培养阳性的患者具有更好的解剖学结局（p = 0.038）和功能结局（p = 0.043）。35例（85%）患者接受了玻璃体切除术及眼内抗生素治疗。分别有23例（56.1%）和12例（29.3%）获得了最佳的解剖学和功能结局。
就眼的完整性和视功能而言，PPTE的预后明显较差。PPTE在男孩中常见，常由植物性物质引起。金黄色葡萄球菌是PPTE中最常见的病原体。创伤后早期就诊以及识别革兰氏阳性菌预后较好。
