Klebsiella Cluster Endophthalmitis following Intravitreal Bevacizumab: Role of Early Detection, Pars Plana Vitrectomy, and Intracameral Moxifloxacin.

AIM: To report the clinical profile, outcomes of early vitrectomy for cluster endophthalmitis developing after intravitreal Bevacizumab (IVB), and discuss the role of prophylactic intracameral moxifloxacin for eyes undergoing combined cataract surgery with IVB. METHODS: Single center, retrospective analysis of 35 consecutive eyes developing post-IVB inflammation. RESULTS: Of the 35 eyes that were administered IVB (27 eyes 'IVB alone' and 8 eyes 'IVB with cataract surgery'). Endophthalmitis developed in 28 eyes, 6 eyes were managed with Intravitreal antibiotic (IVAB) alone, while 22 eyes required early vitrectomy. Only one eye undergoing a combined phacoemulsification with IVB developed endophthalmitis. Majority(26/28) of the eyes achieved visual acuity equal to/greater than pre-IVB injection vision over a period of 3.15 ± 3.2 months. CONCLUSION: Early detection and prompt PPV were effectual for achieving good functional outcomes in our cluster of post-IVB Klebsiella endophthalmitis. Intracameral moxifloxacin was protective in cases undergoing combined cataract surgery with IVB.

Spectral-domain optical coherence tomography and fundus autofluorescence features in a case of typical retinocytoma.

PURPOSE: To report spectral-domain optical coherence tomography (OCT) and fundus autofluorescence (FAF) features observed in a case of typical retinocytoma. METHODS: Case report. RESULTS: A 17-year-old girl on routine ophthalmologic evaluation for headache had an elevated translucent lesion with peripheral pigmentation and adjacent chorioretinal atrophy close to the disc in the nasal retinal quadrant of the left eye. The lesion was confirmed to be retinocytoma on fluorescein angiography. Optical coherence tomography revealed a hyperreflective layer akin to preserved nerve fiber layer overlying the lesion in most of the scans. Symmetrical hyporeflective spaces in the underlying choroid and at places sudden disruption of choroid was also observed in the area of choroidal atrophy. Fundus autofluorescence revealed areas of hyperfluorescence, isofluorescence, and hypofluorescence in the different regions of the lesion. These features on FAF were consistent with posttreatment regressed retinoblastoma. Scleral hyperreflectivity on OCT as well as unmasked hyperfluorescence on FAF was observed in areas of chorioretinal atrophy. CONCLUSIONS: We report novel findings of superficial hyperreflective layer presumed to be preserved nerve fiber layer in a case of typical retinocytoma as well as FAF features consistent with regressed retinoblastoma.