Purpose: To report endogenous fungal endophthalmitis, postrecovery from severe COVID-19 infection in otherwise immunocompetent individuals, treated with prolonged systemic steroids. Methods: Retrospective chart review of cases with confirmed and presumed fungal endogenous endophthalmitis, following severe COVID-19 disease, treated at two tertiary care referral eye institutes in North India. Results: Seven eyes of five cases of endogenous fungal endophthalmitis were studied. All cases had been hospitalized for severe COVID-19 pneumonia and had received systemic steroid therapy for an average duration of 42 ± 25.1 days (range 18–80 days). All the cases initially complained of floaters with blurred vision after an average of 6 days (range 1–14 days) following discharge from hospital. They had all been misdiagnosed as noninfectious uveitis by their primary ophthalmologists. All eyes underwent pars plana vitrectomy (PPV) with intravitreal antifungal therapy. Five of the seven eyes grew fungus as the causative organism (Candida sp. in four eyes, Aspergillus sp. in one eye). Postoperatively, all eyes showed control of the infection with a marked reduction in vitreous exudates and improvement in vision. Conclusion: Floaters and blurred vision developed in patients after they recovered from severe COVID-19 infection. They had received prolonged corticosteroid treatment for COVID-19 as well as for suspected noninfectious uveitis. We diagnosed and treated them for endogenous fungal endophthalmitis. All eyes showed anatomical and functional improvement after PPV with antifungal therapy. It is important for ophthalmologists and physicians to be aware of this as prompt treatment could control the infection and salvage vision.

occlusion (CRVO) to be between 0.1 to 0.4%. The cumulative 10-year incidence of branch retinal vein occlusion (BRVO) in the age group above 49 years has been estimated to be 1.2%. The 15-year cumulative incidences of branch retinal vein occlusion and central retinal vein occlusion were 1.8% and 0.5%, respectively, in a large population based study [2] . In the subsequent sections, we focus on the clinical presentation of these occlusions with their appearances during their natural history and alterations seen on investigations. CENTRAL RETINAL VEIN OCCLUSIONCentral retinal vein occlusion is commonly seen in older individuals, with the prevalence rising sharply over the age of 65 years. The incidence does not vary with sex. Common co-morbidities in individuals with CRVO include hypertension, diabetes, atherosclerotic disease, hematological disorders, vasculitis and autoimmune disorders (in younger individuals). Infective pathologies like HIV, syphilis, are found less frequently. Ocular co-morbidities include glaucoma, retrobulbar compression, optic nerve head drusen and crowded discs [3] . Central retinal vein occlusion (CRVO) spans a clinical spectrum from mild alteration in venous flow apparent as an impending vein occlusion to a very severe predominantly occlusive ischemic CRVO. Based on the quantum of ischemia or capillary non-perfusion in the standard ETDRS fields, the Central retinal Vein Occlusion Study (CVOS) divided this spectrum into three major categories [4] . Ischemic CRVO (ICRVO) cases had more than 10 disc areas of capillary non-perfusion on fluorescein angiography of the eye, whereas non-ischemic CRVO (NICRVO) had less than this degree of non-perfusion. Between these arbitrary categories were a group of eyes where the amount of non-perfusion could not be reliably ascertained on angiography due to blocked fluorescence from retinal hemorrhages. This category was called indeterminate type.Given that CRVO is not a static disease and may progress over time, these categories are not watertight and a large percentage (upto 80%) of indeterminate eyes turn out to be of the ICRVO type on follow up. Upto a third of patients having NICRVO at presentation convert to ICRVO patients over a three-year follow-up. Another TOPIC HIGHLIGHT Clinical Diagnosis of Retinal Vein OcclusionDaraius Shroff, Abhishek Kothari, Gagan Bhatia, Charu Gupta

No abstract