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CLINICAL PRESENTATIONS, DIAGNOSIS, AND MANAGEMENT OUTCOMES OF CURVULARIA ENDOPHTHALMITIS AND A REVIEW OF LITERATURE

Dave, Vivek Pravin, MD, FRCS*; Joseph, Joveeta, MD; Pathengay, Avinash, FRCS; Pappuru, Rajeev R., MD*; Das, Taraprasad, MD*

doi: 10.1097/IAE.0000000000002375
Original Study: PDF Only

Purpose: To describe the clinical presentation and management of Curvularia endophthalmitis and compare with previous published literature.

Methods: Retrospective interventional comparative case series and literature review. Eight cases with culture-proven Curvularia endophthalmitis from January 2000 to March 2018 underwent vitrectomy/vitreous biopsy, intravitreal antibiotic with or without additional procedures as appropriate. The undiluted vitreous biopsy was subjected to microbiologic evaluation. Pre-existing literature was reviewed, and the current outcomes were compared with them. The mean age at presentation, etiology, number of interventions, interval between inciting event and presentation, type of intravitreal antifungal used, anatomical, and the functional outcomes were reported and compared with pre-existing literature. A favorable anatomical outcome was defined as preservation of the globe, absence of hypotony, attached retina, and absence of active inflammation at the last visit.

Results: In the current series, there were 4 men and 4 women. Mean age at presentation was 34.5 ± 13.51 years (median 30 years). Inciting event was open-globe injury in five cases and cataract surgery, trabeculectomy, and endogenous cause in one case each. Presenting visual acuity was ≥20/400 in 3 cases at presentation and 5 cases at the last visit. One case with staphyloma and endophthalmitis underwent evisceration for a painful blind eye. The patients in the current series were much younger than those described previously.

Conclusion: Presentation and diagnosis of Curvularia can be delayed especially in postoperative cases. Early and appropriate management with multiple interventions can result in an acceptable visual and anatomical outcome.

In this article, we describe various outcomes and clinical presentations of a relatively uncommon but clinically significant etiology of endophthalmitis caused by Curvularia. We also summarize the existing literature and compare the outcomes reported previously to the current series

*Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, India;

Jhaveri Microbiology Center, Brien Holden Eye Research Center, LV Prasad Eye Institute, Hyderabad, India; and

Retina and Uveitis Department, LV Prasad Eye Institute, Visakhapatnam, India.

Reprint requests: Vivek Pravin Dave, MD, FRCS, DNB, Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad 500034, Telangana, India; e-mail: vivekoperates@yahoo.co.in

Supported by the Hyderabad Eye Research Foundation.

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.