Paediatric endophthalmitis: a 10-year retrospective study at Hospital Kuala Lumpur for incidence, risk factors, and outcomes

Abstract

Purpose: Paediatric infectious endophthalmitis is a serious sightthreatening disease for children. The purpose of this study was to investigate the incidence, aetiology, microbiological spectrum, management, and visual outcomes of infectious endophthalmitis in children referred to the Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
Study design: Retrospective study.
Methods: The medical records of all patients under 18 years of age with histories of endophthalmitis treated at Hospital Kuala Lumpur from January 2009 to December 2018 were reviewed. The clinical characteristics, aetiology, microbiological spectrum, management, as well as the visual outcomes were analysed.
Results: A total of 23 children were identified, with a mean age of 3.15 (ranging from 20 days to 8 years of age). Previous ocular surgery (47.8%) and ocular trauma (30.4%) were the most common causes of endophthalmitis. Overall, eight (38.1%) cases with positive cultures were identified. The most commonly identified organism was Staphylococcus sp. comprising 50% of the isolates. Moreover, five isolates (62.5%) were gram-positive organisms and three isolates (37.5%) were gram-negative organisms. The final visual outcome was 20/200 or better in one eye (4.3 %), hand movement in two eyes (8.7%), light perception in five eyes (21.7%), and no light perception in 13 eyes (56.5%). The visual outcome was not available for two patients (8.7%).
Conclusions: Previous ocular surgery and penetrating ocular trauma are the most frequent causes of paediatric endophthalmitis in our centre. Staphylococcus sp. was the most commonly identified organism in paediatric endophthalmitis. In this study, despite aggressive management with intravitreal antibiotics and vitrectomy, the visual prognosis was found to be generally poor.