OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND WIDEFIELD FUNDUS AUTOFLUORESCENCE IN PUNCTATE INNER CHOROIDOPATHY.

PURPOSE: To present the optical coherence tomography angiography and widefield fundus autofluorescence (FAF) imaging findings of a 34-year-old woman with punctate inner choroidopathy and Type 2 neovascularization. METHODS: In the retrospective case report, optical coherence tomography angiography imaging was performed with the RTVue XR Avanti (Optovue Inc, Fremont, CA) platform, which uses split spectrum amplitude decorrelation angiography to detect flow. PATIENTS: Single patient with the diagnosis of punctate inner choroidopathy. RESULTS: Spectral domain optical coherence tomography of the macula showed an inactive submacular scar but optical coherence tomography angiography demonstrated the fine detailed structure of a Type 2 neovascular membrane. Peripheral FAF abnormalities were detected despite the notable absence of these lesions with clinical examination and color fundus photography. These FAF findings were important in guiding clinical follow-up and response to therapy. The FAF lesions resolved with normal follow-up and treatment with oral naproxen. DISCUSSION: This is the first case report of optical coherence tomography angiography imaging of choroidal neovascularization associated with punctate inner choroidopathy and the first report of widefield FAF abnormalities in punctate inner choroidopathy. Optical coherence tomography angiography may provide a more noninvasive and sensitive imaging system for the evaluation of choroidal neovascularization than traditional fluorescein angiography and may provide a direct gauge of response to therapy. Widefield FAF may improve detection of inflammatory activity of retinal disease and monitoring of disease activity.

Control of disseminated scedosporium prolificans infection and endophthalmitis.

PURPOSE: To report a case of endogenous endophthalmitis as the presenting sign of a disseminated Scedosporium prolificans infection. METHODS: A 38-year-old woman on chronic immunosuppressive treatment for a cardiac transplant was examined for blurry vision in her right eye. Dilated fundus examination in the right eye revealed a large serous retinal detachment with subretinal cream-colored masses. RESULTS: Complete pars plana vitrectomy with vitreal biopsies was performed and revealed S. prolificans on culture. Multiple intravitreal voriconazole injections as well as systemic voriconazole and terbinafine resulted in control and suppression of both the ocular and systemic disease. CONCLUSION: Scedosporium prolificans endogenous endophthalmitis represents a difficult to treat opportunistic infection in immunocompromised patients. However, newer-generation antifungals offer the potential for suppression of systemic disease and the possibility of avoiding enucleation in the setting of endophthalmitis.