Table 2.
Ocular features, microbiological findings, treatment, and outcome for seven eyes of five cases with endogenous endophthalmitis post COVID-19
| Eye (Case) | 1 (Case 1) | 2 (Case 1) | 3 (Case 2) | 4 (Case 3) | 5 (Case 4) | 6 (Case 5) | 7 (Case 5) |
|---|---|---|---|---|---|---|---|
| Presenting Vision | 20/200 | 20/400 | HM | CFCF | 20/600 | 20/1200 | HM |
| Prior ocular Treatment for uveitis | Topical NSAIDs and prednisolone | Topical NSAIDs and prednisolone | Oral and topical prednisolone | Oral and topical prednisolone f/b PPV | Topical NSAIDs and prednisolone | Oral, topical Prednisolone, periocular triamcinolone | Oral, topical Prednisolone, periocular triamcinolone |
| Anterior segment findings | AC cells 1+, Flare 1+ | AC cells 1+, Flare 1+ | AC cells 2+, Flare 2+PSC Cataract | AC Cells 1+Flare 1+ | AC cells 3+, Flare 3+ | AC cells 3+, Flare 3+NS+PSC cataract | AC cells 3+, Flare 3+NS+PSC cataract |
| Fundus findings | Creamy-white fluffy lesion at posterior pole, break through hemorrhage. | Creamy-white fluffy lesions at posterior pole, break through hemorrhage. | Vitreous exudates with string of pearls appearance. | Vitreous exudates, granuloma nasally and at posterior pole. Total RD. | Vitreous exudates with cotton balls, small retinal abscess inferior to the ONH. | Vitreous exudates with retinal abscess inferotemporal to fovea. | Vitreous exudates with retinal abscess at macula and large subretinal abscess temporally. |
| Organism isolated on culture | Candida sp. | Candida sp. | nil | Aspergillus sp. | nil | Candida sp. | Candida sp. |
| Treatment | PPV with lV voriconazole and silicone oil injection | PPV with IV voriconazole and silicon oil injection | PPV with IV voriconazole and IV antibiotics | Re-Vitrectomy +Lensectomy +RR silicone oil+IV Voriconazole | IV voriconazole f/b PPV with IV voriconazole+IV antibiotics | PPV with IV voriconazole+IV antibiotics | PPV with IV voriconazole+IV antibiotics+silicone oil |
| Postoperative status | Vitreous cavity clear. ERM along the disc to macula | Vitreous Cavity clear. ERM over macula | Vitreous cavity clear PSC cataract + | Vitreous cavity clear, retina attached, retinal abscess resolving | Vitreous cavity clear, area of abscess getting scarred | Vitreous cavity clear, area of abscess getting scarred | Vitreous cavity clear, area of central abscess getting scarred, other abscesses resolving |
| Final Vision | 20/80 | 20/40 | 20/200 | 20/1200 | 20/40 | 20/80 | CFCF |
| Follow up | 24 weeks | 24 weeks | 16 weeks | 10 weeks | 8 weeks | 8 weeks | 8 weeks |
NSAID=Nonsteroidal antiinflammatory drugs, PPV=Pars plana vitrectomy, PSC=Posterior subcapsular, IV=Intravitreal, AC=Anterior chamber, HM=Hand movements, CFCF=Counting fingers close to face, ERM=Epiretinal membrane, RR=Relaxing retinotomy, and RD=Retinal detachment