Treatment outcome in endogenous fungal endophthalmitis. (IMAGE)
Caption
Treatment outcome in endogenous fungal endophthalmitis. a An 80-year-old patient presented with light perception vision in the right eye. Vitreous tap was negative for organisms and growth. Subsequent pars plana vitrectomy with sub-retinal exudate biopsy confirmed a Candida albicans infection, presumably secondary to antecedent colonoscopy. In addition to diagnostic and therapeutic vitrectomy, the patient was treated with intravitreal and systemic voriconazole, resulting in the resolution of subretinal exudate but minimal improvement in vision (hand movements at 50 cm). b A 72-year-old male on steroids for chronic obstructive pulmonary disease was referred from a tertiary referral hospital, where he had been admitted for the management of presumed endogenous endophthalmitis. The presenting vision was light perception. Previous pulmonary imaging revealed right upper lobe masses; bronchoscopy excluded malignancy and mycobacterial infection, though cultures were negative. Initial pars plana vitrectomy and vitreous microscopy, culture, and polymerase chain reaction were negative. A sub-retinal biopsy following pars plana vitrectomy (right and left eyes, 1 week following surgery in the right eye) confirmed Scedosporium apiospermum infection. This was managed with intravitreal and systemic voriconazole. The patient subsequently demonstrated resolution of infection but developed a retinal detachment under oil with no improvement in vision.
Credit
Eye and Vision
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