David Hille1,2, Pavindran Gounder1,3, Fred Chen1,4,5
Purpose: To describe the clinical features, manage- ment and outcomes of culture-proven endogenous fungal endophthalmitis (EFE).
Method: A chart review of patients who presented to any of the 3 Western Australian tertiary ophthalmol- ogy departments with EFE between 2000 and 2015.
Results: Twenty-four eyes of 19 patients with EFE were identiﬁed. The mean (SD) age was
47 (17) years. Fifty-eight percent were males and 32% were from rural areas. The most prevalent risk factors were intravenous drug use (IVDU, 10 patients, 54%) and Hepatitis C (5; 26%). Mean (logMAR, SD, range) presenting visual acuity was
1.45 (0.86, 6/5 to perception of light only) for
24 eyes. The most prevalent fungal isolate was Candida albicans (7; 37%), followed by Candida tropi- calis (4; 21%) and Scedosporium apiospernum (4;
21%). Eighteen of the 19 (95%) patients had vitre- ous sampling but only 14 (78%) were conﬁrmed fungal. The remaining 5 patients were conﬁrmed through blood or urine culture. Sensitivities were reported in 10 (53%) patients and all were suscepti- ble to ﬂuconazole. Fourteen eyes of 13 (68%) patients underwent vitrectomy. Two (11%) patients with bilateral EFE died and 3 (16%) underwent enucleation. Of the surviving 17 patients, accounting for 20 eyes, six eyes (30%) had a decline in VA. Vitrectomy did not inﬂuence VA out- come (P = 0.28).
Conclusion: IVDU is the most common risk factor for EFE whilst Candida albicans was the most preva- lent pathogen. Most fungal pathogens were sensitive to ﬂuconazole. EFE has a high mortality and morbid- ity despite aggressive systemic and local treatment.
COMPARISON OF RANIBIZUMAB AND AFLIBERCEPT IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION TREATED FOLLOWING A ?TREAT AND EXTEND? PROTOCOL: EFFICACY VARIABLES FROM THE PRE-SPECIFIED 12- MONTH INTERIM ANALYSIS OF THE RIVAL STUDY