Endogenous Endophthalmitis in Children: A 5-Year Retrospective Study in Vietnam

To describe the findings and outcomes in pediatric endogenous endophthalmitis cases over a 5-year period in Vietnam.

All cases of pediatric endogenous endophthalmitis seen at Vietnam National Eye Hospital from 2016 to 2020 (n = 157) were retrospectively studied. Data on epidemiology, microbiology, clinical manifestations, ultrasound findings, and outcomes were collected and analyzed. Success was defined as visual acuity of counting fingers at 1 meter or better if visual acuity testing could be done, and a fully attached retina, controlled intraocular pressure, and no phthisis bulbi.

The mean patient age was 6.0 ± 3.8 years. Gram-positive cocci were the most common causative agents (45.2%), followed by Gram-negative bacilli (10.8%). Among 31 cases in which both vitreous and aqueous specimens were collected, 17 (54.8%) showed discordant microbiological results. The overall treatment success rate was 38.2%. An initial visual acuity better than light perception was associated with a higher success rate (45.8% vs 16.7%, P < .05). Children presenting with ultrasound grade 3 vitreous opacity had a lower success rate compared to those with grades 1 and 2 combined (38.1% vs 69.6%, P < .05).

Gram-positive cocci were the most frequently identified pathogens in children with endogenous endophthalmitis in Vietnam. The low agreement between smear stain and culture results indicates that using both methods could enhance diagnostic accuracy. Initial visual acuity at admission and the degree of vitreous opacity were recognized as important prognostic factors for treatment outcomes.