Relation between stage of endogenous fungal endophthalmitis and prognosis

Abstract

Because the stage of EFE advanced with the time between the initial symptoms and the beginning of therapy, and because of the high correlation between the stage of EFE and the final visual acuity, it is very important that treatment be begun as soon as possible. Thus, in patients with visual symptoms and susceptible to opportunistic infections, an early consultation with an ophthalmologist is highly recommended.

The Role of Early Vitrectomy in the Treatment of Fungal Endogenous Endophthalmitis

“…In contrast, all of the cases in this series received a vitrectomy followed by intravitreal antifungals within 24 hours of suspected endophthalmitis. This is different from studies where vitrectomy was delayed after eyes did not respond to medical therapy or reserving it for severe cases only 8,9 and may explain the better final visual acuities.…”

“…2 This series found that one eye had a retinal detachment one month after vitrectomy that was successfully reattached; this patient also had A. fumigatus and a delayed diagnosis of 1 month, two factors that are associated with poorer outcomes. 2,8 In eyes with culture-proven FEE that underwent vitrectomy from 1990 to 2009, retinal detachment was reported in 17 of 59 eyes (29%). However, distinction between vitrectomy as the initial treatment versus during the course of treatment is not reported.…”

“…7 Similarly, in another review from 1984 to 2004, 13 of 29 vitrectomized eyes (44%) achieved a visual acuity of 20/200 or better. 8 Shen and Xu 9 found that from 2002 to 2006, 11 of 29 vitrectomized eyes (38%) had a final visual acuity of 20/ 200 or better. Five of these eyes received an immediate vitrectomy because the amount of vitritis was considered too severe at initial presentation for medical therapy.…”

Retina translocation for a patient with endogenous fungal endophthalmitis: long-term follow-up

“…A review of the literature has revealed only a few other cases of endogenous fungal endophthalmitis (EFE) in immunocompetent patients [4,8,9]. Since the initial presentation of the EFE is a non-specific choroidoretinitis with no typical characteristics for differentiation except the risk factors for fungal disease, it is hard to make an early diagnosis of EFE in patients without any underlying diseases.…”

Aspergillus terreusEndogenous Endophthalmitis in a Nonimmunocompromised Patient with a History of Bronchiectasis

“…7,11 Chronic pulmonary aspergillosis is a smouldering infection that is hard to diagnose and identify systemically. A. fumigatus is almost always the causative organism.…”