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Ella Hoshuen Leung, Ajay E. Kuriyan, Harry W Flynn, Darlene Miller, Laura Huang; Persistently Vitreous Culture Positive Exogenous Fungal Endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4514.
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© ARVO (1962-2015); The Authors (2016-present)
To identify the fungal organisms and determine the clinical outcomes of patients with persistently vitreous-proven fungal endophthlamitis.
A retrospective review of all patients with at least 2 vitreous cultures positive for the same exogenous fungal endophthalmitis at a university referral center from 1981 to 2011. All patients received intravitreal antifungal injections.
Eight eyes of 8 patients were included. The mean age was 62.4 years old, and the mean follow up was 77.6 months (range: 4-288 months). The organisms were Candida albicans (n=2), Aspergillus (n=1), Acremonium (n=1), Curvulara sp (n=1), Dematicaous (n=1), Helicomyces (n=1), and Fusarium (n=1). The most common etiologies were after cataract surgery (n=3), trauma (n=2), corneal ulceration (n=2), and combined glaucoma/cataract surgery (n=1). An average of 2.63 ± 1.9 months elapsed from the surgery or trauma to the development of endophthalmitis; the mean time to the second treatment was 1.19 ± 1.9 months. Five patients (62.5%) underwent an initial tap/inject of antifungals; their mean presenting visual acuity was similar to those who underwent an initial pars plana vitrectomy (p=0.36). The mean initial visual acuity for all patients was 2.03 ± 0.70 logMAR, and the vision did not improve significantly at the last follow up (1.55 ± 1.2 logMAR, p=0.36). Patients had an average of 2.75 injections of antifungals. Three eyes were enucleated at the last follow up (37.5%, 3/8). Only 2 eyes (25%, 2/8) had final visual acuities better than 20/200
Patients with persistently vitreous culture positive fungal endophthalmitis have poor visual outcomes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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