Rothschild Ophthalmological Foundation, Hôpital Fondation Adolphe de Rothschild, 25 Rue Manin, 75940, Paris Cedex 19, France.
Graefes Arch Clin Exp Ophthalmol. 2021 Nov;259(11):3405-3412. doi: 10.1007/s00417-021-05340-8. Epub 2021 Aug 17.
To investigate the clinical profile and visual outcomes of infectious endophthalmitis in children at a single tertiary hospital in France, and propose an evidence-based protocol for management.
This is a retrospective monocentric study that involved children with a history of endophthalmitis between January 2008 and January 2020. The clinical characteristics, etiology, microbiological spectrum from aqueous/vitreous tab, anatomical and visual outcomes, and management were analyzed. The Fischer and chi-square tests were used in the statistical evaluation.
Twenty-six children were eligible for inclusion. The mean patients age at presentation was 4.2 years (range, 8 days-14.3 years). With regard to etiology, patients were divided into posttraumatic group (n = 7 (26.9%)), postoperative group (n = 15 (57.7%)), endogenous group (n = 3 (11.5%)), and infectious corneal ulcer group (n = 1 (3.9%)). Time-to-onset of symptoms was highest in children ≤ 3 years old and in the postoperative subgroup who had at least one glaucoma procedure. Microbiology results showed growth in 12/26 (46.2%). The most common microorganism identified was Streptococcus pneumoniae (5/12 (41.7%)). The antibiotic regimen varied depending on age, organism, and sensitivities. The final visual outcomes were 20/200 or better in 11/26 (42.3%) eyes, and 13/26 (50.0%) eyes had no light perception. Twelve of twenty-six (46.2%) eyes ended up with phthisis bulbi.
Pediatric endophthalmitis is a rare but devastating condition with poor visual prognosis, requiring prompt recognition and treatment. Despite aggressive management with antibiotics and vitrectomy, the visual prognosis is generally poor. A protocol for management with an adapted systemic antibiotic therapy is proposed in order to improve outcomes.
研究法国一家三级医院儿童感染性眼内炎的临床特征和视力结果，并提出基于证据的管理方案。
这是一项回顾性单中心研究，纳入了 2008 年 1 月至 2020 年 1 月期间患有眼内炎的儿童患者。分析了临床特征、病因、房水/玻璃体液培养的微生物谱、解剖学和视力结果以及治疗方法。统计评估采用 Fischer 和卡方检验。
26 名患儿符合纳入标准。患儿就诊时的平均年龄为 4.2 岁（8 天至 14.3 岁）。根据病因，患儿分为创伤后组（7 例，26.9%）、手术后组（15 例，57.7%）、内源性组（3 例，11.5%）和感染性角膜溃疡组（1 例，3.9%）。≤3 岁的患儿和至少接受过一次青光眼手术的术后组患儿的症状出现时间最长。26 例患儿中有 12 例（46.2%）培养出微生物。最常见的病原体是肺炎链球菌（5/12，41.7%）。抗生素方案根据年龄、病原体和药敏试验而有所不同。最终视力结果为 26 只眼中 20/200 或更好的有 11 只（42.3%），无光感的有 13 只（50.0%）。26 只眼中有 12 只（46.2%）最终发生眼球萎缩。
儿童眼内炎是一种罕见但严重的疾病，视力预后较差，需要及时识别和治疗。尽管采用抗生素和玻璃体切除术进行积极治疗，但总体视力预后仍较差。为了改善预后，提出了一种管理方案，包括了适应性的全身抗生素治疗。
