ENDOGENOUS ASPERGILLUS ENDOPHTHALMITIS IN AN IMMUNOCOMPETENT PATIENT WITH A REMOTE HISTORY OF PULMONARY TUBERCULOSIS.

PURPOSE: To report a case of Aspergillus fumigatus endogenous endophthalmitis in an immunocompetent patient initially diagnosed as acute retinal necrosis. METHODS: Case report. PATIENT: A 67-year-old woman with a remote history of treated pulmonary tuberculosis and no ocular history presented to an outside retina specialist with a sudden onset of floaters and blurred vision in one eye. Examination and fluorescein angiography at the time revealed findings suspicious for acute retinal necrosis, and the patient was started on oral valganciclovir and an intravitreal injection of ganciclovir. Despite treatment, the patient's vision and pain worsened. After evaluation at the University of Southern California Roski Eye Institute, she was diagnosed with a likely fungal endogenous endophthalmitis based on ultrasound findings and underwent emergent vitrectomy. A chest x-ray demonstrated partial collapse of the right upper lobe with hilar enlargement. RESULTS: Aspergillus fumigatus was cultured from vitreous, blood, and bronchoalveolar lavage samples, suggesting that the patient's infection had a pulmonary origin, most likely from the right upper lobe that had healed from previous tuberculosis infection. DISCUSSION: To the best of our knowledge, this is the first reported case of Aspergillus endogenous endophthalmitis in an immunocompetent patient secondary to pulmonary changes that occurred from previously treated tuberculosis.

Retinal vessel changes after laser treatment for retinopathy of prematurity.

BACKGROUND: The clinical response to retinopathy of prematurity (ROP) treatment is currently assessed subjectively. This study aims to quantify treatment response objectively by assessing changes in digital images of posterior pole retinal vessel width and tortuosity. METHODS: Images of 30 right eyes with type 1 ROP obtained at up to three time points were analyzed: before treatment (T = 0) and 1 (T = 1) and/or 2 weeks (T = 2) after treatment. Width and tortuosity of retinal vessels were analyzed from digital images using computer-assisted image analysis software. RESULTS: Vessel width decreased by 20% (P < 0.004) within the first week and remained stable by the second week after laser treatment. Vessel tortuosity did not significantly change by the first week but decreased 27% (P < 0.01) by second week. CONCLUSIONS: Vessel width appears to decrease dramatic within the first week, whereas the regression of tortuosity follows a slower course.