ABSTRACT
This case report describes three eyes of two patients, who were diagnosed to have endogenous fungal endophthalmitis post coronavirus disease 2019 (COVID-19) infection. Both patients underwent vitrectomy with intravitreal anti-fungal injection. Intra-ocular samples confirmed the fungal etiology by conventional microbiological investigations and polymerase chain reaction in both cases. The patients were treated with multiple intravitreal and oral anti-fungal agents; however, vision could not be salvaged.
Subject(s)
COVID-19 , Endophthalmitis , Eye Infections, Fungal , Humans , Eye Infections, Fungal/diagnosis , Eye Infections, Fungal/etiology , Eye Infections, Fungal/drug therapy , Endophthalmitis/diagnosis , Endophthalmitis/etiology , Endophthalmitis/drug therapy , Vitrectomy , Intravitreal Injections , Antifungal Agents/therapeutic use , Retrospective StudiesABSTRACT
OBJECTIVE: To examine the inter-observer agreement between two retina specialists in grading diabetic retinopathy (DR) severity in ultra-wide-field fundus photographs. METHODS: Two hundred and seventy patients with diabetes, who visited the vitreoretinal specialty at a tertiary eye care hospital, with or without DR underwent comprehensive ophthalmic examination, dilated retinal exam and Optos ultra-wide-field (UWF) retinal photography. Optos images were graded for DR severity based on the International Clinical Diabetic Retinopathy Disease Severity Scale by two retina specialists with same number of years of experience, masked to the clinical details of the participants. RESULTS: The two graders showed agreement in 229/270 images (84.8%) and disagreement in 41/270 images (15.2%). The unweighted kappa for agreement between graders was k = 0.715, SE = 0.037 and the weighted kappa was k = 0.838, SE = 0.022. No DR was identified in 170/270 (62.9%) patients, mild NPDR in 15/270 (5.6%) patients, moderate NPDR in 35/270 (12.9%) patients, severe NPDR in 4/270 (1.48%) patient and PDR in 5/270 (1.85%) patients by both graders. Disagreement was neither related to the learning curve of graders nor with the patient's age (p = 0.574), gender (p = 0.169), duration of diabetes (0.660) or the lens being phakic or pseudophakic (p = 0.171) on logistic regression. CONCLUSIONS: The impact of disagreement noted between observers in grading DR on UWF fundus photographs should be considered when utilizing UWF system in clinical studies.
Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Humans , Diabetic Retinopathy/diagnosis , Observer Variation , Retina , Diagnostic Techniques, Ophthalmological , Fundus Oculi , Photography/methodsABSTRACT
A 13-year-old boy developed painless diminution of vision in left eye 15 days after taking first dose of coronavirus disease 2019 (COVID-19) vaccine (Corbevax). Fundus and fluorescein angiography revealed central retinal vein occlusion in the left eye. Blood investigations were noncontributory. He was administered three doses of pulse corticosteroids followed by a tapering dose of oral corticosteroids. Retinal vascular occlusion can occur following COVID-19 vaccination in children, and early and aggressive systemic anti-inflammatory therapy can be helpful.
Subject(s)
COVID-19 Vaccines , COVID-19 , Retinal Vein Occlusion , Adolescent , Anti-Inflammatory Agents/therapeutic use , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Child , Fluorescein Angiography , Humans , Male , Retinal Vein Occlusion/chemically induced , Retinal Vein Occlusion/diagnosis , Retinal Vein Occlusion/drug therapy , VaccinationSubject(s)
Diabetic Retinopathy/drug therapy , Macular Edema/drug therapy , Patient Acceptance of Health Care/statistics & numerical data , Patient Compliance/statistics & numerical data , Text Messaging/statistics & numerical data , Aged , Angiogenesis Inhibitors/therapeutic use , Female , Humans , Intravitreal Injections , Male , Middle Aged , Single-Blind Method , Smartphone/instrumentationABSTRACT
A 23-year male with complaint of diminution of vision in left eye was referred to us as a suspect case of inflammatory choroidal mass/melanoma. Examination revealed a total retinal detachment with a reddish brown lesion in the superior hemi-fundus. B-scan ultrasonography demonstrated the 'mass' to be intra-retinal without choroidal involvement. A diagnosis of haemorrhagic intraretinal macrocyst (HIM) was made. We report this case to highlight the importance of correctly diagnosing an HIM and utilizing ultrasound to rule out choroidal pathologies, especially melanoma. This is essential as the management and prognosis of the two disorders is entirely different.
ABSTRACT
A 60-year-old male presented with pain and decreased vision 3 weeks following uneventful intracapsular cataract extraction with anterior vitrectomy for subluxated cataract. A diagnosis of acute endophthalmitis was made based on clinical and ultrasound features. Patient improved only after undergoing pars plana vitrectomies twice and repeated intravitreal antibiotic-steroid injections. Vitreous aspirate revealed Gram-negative bacillus identified as Pseudomonas luteola on culture. Patient returned with a retinal detachment at first follow-up which was treated with vitrectomy, endolaser, and silicone oil tamponade. To the best of our knowledge, this is the first case of P. luteola causing acute onset, virulent endophthalmitis reported in literature.
