Ultrasound Biomicroscopy Pars Plana Fungal Foci In Postoperative Endophthalmitis
Published 2023 - 41st Congress of the ESCRS
Reference: PP07.08 | DOI: 10.82333/6ntv-y890
Authors: Erika Jean Salvame* 1 , Jocelyn Sy 2
1Ophthalmology,Manila Doctors Hospital,Caloocan,Philippines;Ophthalmology,East Avenue Medical Center,Quezon,Philippines, 2Ophthalmology,East Avenue Medical Center,Quezon,Philippines
To describe an occurrence of persistent post-cataract surgery endophthalmitis presenting with foci of fungal deposit at the pars plana seen by ultrasound biomicroscopy and endoscopic vitrectomy
This is case report from a tertiary hospital from a developing country
This is a case report
A 55 yo male underwent complicated phacoemulsification. 1 week postop, VA decreased to hand movement (HM) with hypopyon. No improvement on intravitreal antibiotics prompted pars plana vitrectomy. Vision improved to 20/80 but by 1 month post-operation, VA decreased to HM. B-scan revealed vitritis. Pre-operative ultrasound biomicroscopy revealed a hyperechoic nodule at the pars plana extending to the adjacent detached retina. Patient underwent intraocular lens explantation, and retinal detachment surgery. Intra-operative endoscopic evaluation revealed cream feathery mounds at the pars plana. Microbiological workup revealed spores and pseudohyphae suspicious of candida species. Intravitreal and systemic anti-fungal treatment was initiated.
Fungal endophthalmitis is a potentially devastating postoperative complication. Its clinical course is nonspecific and can be confounded by initial improvement and low grade prolonged inflammation. This case highlights the importance of multimodal platforms of imaging in identifying foci of infections. Adjunct intraoperative visualization platforms may also aid in better yield of samples for diagnostic evaluation.