Pediatrics, University of Helsinki and Helsinki University Hospital, Stenbäckinkatu 9, 00029, Helsinki, Finland.
New Children's Hospital, Pediatric Research Center, P.O. Box 347, 00029 HUS, Helsinki, Finland.
Sci Rep. 2023 Sep 19;13(1):15530. doi: 10.1038/s41598-023-41685-2.
Although rarely reported, bilateral loss of vision is a severe complication of childhood bacterial meningitis. We assessed its frequency in five prospective treatment trials performed in Europe, Latin America, and Angola in 1984-2017. Course of illness, follow-up findings, and child's sight were recorded. Sight was examined at discharge, and conditions permitting, also at 1-3 months post-hospitalization and in Angola on hospital day 7. Experienced pediatricians diagnosed clinical blindness if the child did not make eye contact, did not blink or move the eyes, or remained unresponsive to bright light or movement of large objects before their eyes. Of 1515 patients, 351, 654, and 510 were from Finland, Latin America, and Angola, respectively. At discharge, blindness was observed in 0 (0%), 8 (1.2%), and 51 (10%) children, respectively. In Angola, 64 children appeared to be blind on day 7; 16 of these children died. Blindness found at discharge in Angola was not invariably irreversible; approximately 40% had restored the sight at follow-up visit. Clinical blindness rarely occurred in isolation and was usually associated with young age and poor general condition at hospital arrival. Various other serious sequelae were common among the survivors with clinical blindness.
虽然很少有报道，但双侧失明是儿童细菌性脑膜炎的一种严重并发症。我们评估了其在 1984 年至 2017 年期间在欧洲、拉丁美洲和安哥拉进行的五项前瞻性治疗试验中的发生率。记录了病程、随访结果和患儿的视力情况。患儿出院时进行视力检查，如果条件允许，还在出院后 1-3 个月以及在安哥拉住院第 7 天进行检查。有经验的儿科医生会根据患儿是否无法进行眼神交流、是否眨眼或转动眼球、是否对强光或眼前移动物体没有反应来诊断临床失明。在 1515 名患儿中，分别有 351 名、654 名和 510 名来自芬兰、拉丁美洲和安哥拉。出院时，分别有 0（0%）、8（1.2%）和 51（10%）名患儿失明。在安哥拉，有 64 名患儿在第 7 天被认为失明，其中 16 名患儿死亡。在安哥拉发现的出院时失明并不总是不可逆转的；大约 40%的患儿在随访时恢复了视力。临床失明很少孤立发生，通常与入院时年龄较小和一般状况较差有关。在有临床失明的幸存者中，还有各种其他严重后遗症。
