Retrospective review of endophthalmitis in our hospital in the last 10 years.

1. Endophthalmitis incidence
and clinical features in a
pediatric ophthalmologic
tertiary hospital
Jaume Català Mora, MD
Gemma Gelabert Colomer, PhD.
Jesús Díaz Cascajosa, MD
Sandra Gómez Sánchez, MD
Joan Prat Bartomeu, MD, PhD

2. Introduction & Objective
• Pediatric non traumatic endophthalmitis is
a rare intraocular infection that leads to
blindness in a high percentage of cases
• Hospital Sant Joan de Déu:
– Tertiary pediatric hospital in Barcelona
– Ophthalmology department:
• 4000 first-visits/year
• 13.625 successive-visits
• 1000 surgeries/year.

3. Objective & Methods
• Objective: retrospective study of non traumatic
endophthalmitis cases attended in our institution the last
10 years (2001-2011)
• Retrospective review of patient’s chart:
– 1) age and gender
– 2) etiology & involved eye
– 3) initial treatment
– 4) culture results
– 5) final visual acuity, additional procedures & status of the eye
• Ocular fluid specimens and wound cultures were
obtained aseptically in the operating room and sent to
microbiology for gram stain, culture, and sensitivity
testing

4. Surgical procedures/year
*:postop endophtalmitis case
The overall incidence of postoperative endopthalmitis in our
hospital is 0.04 %

5. Summary of endophthalmitis
cases
Case Age/Sex Etiology/Eye Initial Tx Culture Final VA;status
No
1 10m/F Strabismus/RE Intravitreal S.epidermidis
LP/eviscerated
2 18m/M Goniotomy/LE Intravitreal S.pneumoniae HM/Phaco+IOL
Suture
3 4y/F Intravitreal S.pneumoniae HM/vitrectomy
extraction/LE
4 11m/F Ahmed valve/LE Intravitreal S.pneumoniae LP/vitrectomy
5 4y/M Lensectomy/LE Intravitreal No growth 20/30; IOL
6&7 10d/M Endogenous/OU Vitrectomy P.aeruginosa HM/LP

6. Discussion
• Endophthalmitis in pediatric patients is a rare event. The incidence
in our hospital is 4/10000 surgeries
• Intraocular surgery is at greater risk of endophthalmitis although it
can also happen after strabismus surgery, especially in case of
penetrating sutures
• Despite the early and the aggressive treatment: intravitreous
injections of ceftazidime & vancomicine, endovenous antibiotics and
vitrectomy when needed the visual prognosis is still poor
• Intravitreal antiVEGF treatment is an expanding treatment in
children. Although we have not had any case of endophthalmitis
post intravitreal injection in infants this risk should be considered
and balanced in the management of this patients

7. Bibliography
Thordsen JE, Harris L, Hubbard GB. Pediatric endophthalmitis: a 10 year consecutive series.
Retina 2008; 28: S3-S7
Huang S, Crawford B, Rutar T. Pathological findings in poststrabismus surgery
endophthalmitis. JAAPOS 2011; 15: 98-100
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