Ophthalmic diseases in meningitis within the pediatric population

Jia Yue You; Milad Modabber; Massimo Di Iorio; Daniela Toffoli

doi:10.1016/j.jcjo.2023.11.002

Ophthalmic diseases in meningitis within the pediatric population

Can J Ophthalmol. 2023 Nov 27:S0008-4182(23)00361-7. doi: 10.1016/j.jcjo.2023.11.002. Online ahead of print.

Authors

Jia Yue You¹, Milad Modabber², Massimo Di Iorio³, Daniela Toffoli⁴

Affiliations

¹ Departments of Ophthalmology and Pediatric Surgery, Montreal Children's Hospital, McGill University, Montreal, QC. Electronic address: iayue.you@outlook.com.
² Herzig Eye Institute, Toronto, ON.
³ Princess Margaret Cancer Centre, University Health Network, Toronto, ON.
⁴ Departments of Ophthalmology and Pediatric Surgery, Montreal Children's Hospital, McGill University, Montreal, QC; Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, QC.

PMID: 38036046
DOI: 10.1016/j.jcjo.2023.11.002

Abstract

Objective: Meningitis may lead to ophthalmic complications in pediatric populations. The visual aftermath in developed countries has been poorly studied. This study aims to highlight the potential ocular and neuro-ophthalmic sequela of meningitis in the pediatric population of a tertiary pediatric hospital.

Design: A retrospective chart review of all pediatric patients, between 2006 and 2015, diagnosed with meningitis at the Montreal Children's Hospital was conducted. Study approval was obtained by the Institutional Review Board of the McGill University Health Centre and adhered to the tenets of the Declaration of Helsinki.

Methods: Records of all pediatric meningitis patients were extracted and further refined by isolating all who received an ophthalmology consultation. Relevant demographic data, general medical information, ocular findings, and imaging results were extracted. The proportion of ocular abnormalities was calculated and analyzed.

Results: Seventy-two of 861 meningitis patients (8.4%) received an ophthalmology consultation. Forty-six patients met the inclusion criteria, and 31 of those (67.4%) demonstrated ocular abnormalities. Children presented most frequently with abnormalities involving visual acuity (8 of 32), extraocular movements and alignment (14 of 28), optic nerve (10 of 41), pupillary reactivity (4 of 35), and periorbital/orbital cellulitis (4 of 46). Older patients were more likely to have ophthalmologic findings.

Conclusion: This chart review highlights the ocular abnormalities found in children who suffer from meningitis and present to a tertiary-care centre in a high sociodemographic index country. Complications may be lasting. Treating ophthalmologists should be cognizant of potential ocular abnormalities among meningitis patients. We advocate for increased awareness of this association among health care providers.