Table 3.
Reports of cryptococcal endophthalmitis cases in non-HIV/non-transplant patients.
| Author | Year | Age | Sex | Clinical presentation | Underlying disease | Diagnostic method | Systemic treatment | Intravitreal treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| Present study | 2025 | 50 | F | Blurred vision, LE | Lung adenocarcinoma with pleural, liver, bone, and leptomeningeal metastases | Vitreous culture: C. neoformans | IV amphotericin B → liposomal amphotericin B and flucytosine (total 5 weeks) → flucytosine and fluconazole → fluconazole | IVT amphotericin B → IVT voriconazole | VA: LE 6/96 + 2 (after induction phase) |
| VA: FC | Serum cryptococcal antigen positive | LE 3/60 (10 months after treatment) | |||||||
| Hiss et al. [9] | 1988 | 63 | M | Clouding of vision, RE | Polyarteritis nodosa, treated with oral prednisone therapy, tapered over a 10-month period from 60 mg to 12.5 mg daily | Fine-needle aspiration biopsy of a solitary fluffy retinovitreal mass: C. neoformans | IV amphotericin B 40 mg/day and flucytosine 2.5 g every 6 hours | IVT amphotericin-B | VA: RE 6/6 |
| VA: 6/18 | |||||||||
| Crump et al. [10] | 1992 | 87 | F | Blurred vision, RE | Hypertension, angina pectoris, and congestive heart failure | Vitreous cytology: encapsulated, budding yeasts | Fluconazole for 5 months | – (vitrectomy) |
VA: RE FC |
| VA: FC | Blood, CSF, and vitreous cultures: C. neoformans | Deceased (due to cryptococcal meningitis after fluconazole discontinuation) | |||||||
| Shwu-Jiuan et al. [11] | 1998 | 45 | F | Progressive painless visual loss, LE | SLE with lupus nephritis | Retina biopsy | IV amphotericin B 20 mg/day for 20 days and fluconazole 400 mg/d for 6 weeks | IVT amphotericin B | – |
| History of long-term use of systemic corticosteroid | |||||||||
| Vela et al. [12] | 2009 | 84 | F | Progressive painless visual loss, LE | Repeated urinary infections treated with systemic antibiotics | Vitreoretinal biopsy | IV amphotericin B 20 mg/day, flucytosine 2.5 g every 6 hours, and voriconazole therapy | IVT amphotericin B | VA: LE HM |
| VA: HM | Retinal lesion remained unchanged | ||||||||
| Amphornphruet et al. [13] | 2018 | 45 | F | Hypopyon with severe vitritis, LE | Unremarkable, except for a previous craniotomy with ventriculoperitoneal shunt for an unidentified brain tumor more than 10 years prior | Vitreous culture: C. neoformans | IV amphotericin B | Bilateral IVT of amphotericin B (5 μg), twice a week for 1 month | VA: LE HM |
| Multifocal chorioretinitis at macula, RE | CSF culture: C. neoformans | RE 20/800 | |||||||
| Serum cryptococcal antigen: positive | |||||||||
| Peck et al. [14] | 2020 | 66 | M | Blurred vision | Myasthenia gravis treated with chronic prednisolone therapy of 20 mg/day and metastatic thymic carcinoma, which was treated with carboplatin and paclitaxel (last 9 days prior to presentation) | Vitreous Gram stain: yeast | Voriconazole therapy → | IVT voriconazole → | VA: RE 20/60 |
| VA: RE 20/400 -1 | Vitreous and CSF cultures: C. neoformans | IV amphotericin B 5 mg/kg every 24 hours, and flucytosine 1750 mg every 6 hours | IVT amphotericin 5 mg/0.1 mL, twice a week for 3 weeks | ||||||
| LE 20/50 | CSF and serum cryptococcal antigen: positive | ||||||||
| Tang et al. [15] | 2024 | 57 | F | Progressive visual loss, RE VA: 20/40 |
Immunocompetent woman | CSF cryptococcal antigen: positive | IV amphotericin B, fluconazole, and flucytosine | IVT amphotericin B (vitrectomy, trans-scleral cryotherapy) | VA: RE 20/30 |
Abbreviations: M, male; F, female; LE, left eye; RE, right eye; VA, visual acuity; FC, finger count; IV, intravenous; IVT, intravitreal injection therapy; HM, hand motion; SLE, systemic lupus erythematosus.