September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Persistently Vitreous Culture Positive Exogenous Fungal Endophthalmitis
Author Affiliations & Notes
  • Ella Hoshuen Leung
    Ophthalmic Research Institute, Bascom Palmer Eye Institute/ University of Miami, Miami, Florida, United States
  • Ajay E. Kuriyan
    Ophthalmic Research Institute, Bascom Palmer Eye Institute/ University of Miami, Miami, Florida, United States
  • Harry W Flynn
    Ophthalmic Research Institute, Bascom Palmer Eye Institute/ University of Miami, Miami, Florida, United States
  • Darlene Miller
    Ophthalmic Research Institute, Bascom Palmer Eye Institute/ University of Miami, Miami, Florida, United States
  • Laura Huang
    Ophthalmic Research Institute, Bascom Palmer Eye Institute/ University of Miami, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Ella Leung, None; Ajay Kuriyan, None; Harry Flynn, None; Darlene Miller, None; Laura Huang, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4514. doi:
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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)

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Abstract

Purpose : To identify the fungal organisms and determine the clinical outcomes of patients with persistently vitreous-proven fungal endophthlamitis.

Methods : 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.

Results : 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

Conclusions : 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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