Endophthalmitis – Diagnosis and Management of Viral, Bacterial, Fungal, Parasitic

A/Prof Samantha Fraser-Bell and Dr Robyn Troutbeck

Meeting:  2018 RANZCO


Date:      -

Session Title: SYMPOSIUM

Session Time:      -

Synopsis: Endophthalmitis of all causes can cause significant vision loss and even be life threaten- ing. Diagnosis of the causative agent and management can be challenging. This symposium aims to summarise the diagnosis and management of endogenous and exogenous endophthalmitis. The sym- posium will be headlined by Russell N Van Gelder, MD, who is the invited uveitis speaker this year. His laboratory has been at the forefront of pathogen detection in uveitis. Endophthalmitis is the most feared post-operative and now post injection complication. A significant proportion have negative vitreal cultures. (1) Culture negative endophthalmitis: Russell N Van Gelder, MD. Dr Van Gelder has identified Torque Teno Virus in culture negative endophthalmitis specimens by representational deep DNA sequencing. He will talk about the possible implication this may have on the pathogenesis of culture negative endophthalmitis. (2) Endophthalmitis – all speakers on stage at once as there may be some panel discussion of salient points. Case reports will be used to present salient features of each condition. (a) Differentiating endogenous endophthalmitis (viral, bacterial, parasitic, fungal) using clinical features and multimodal imaging (including OCT findings): Dr Sophia Zagora, (b) Bac- terial endophthalmitis management: concentrating on Klebsiella – an emerging trend in Australia: A/ Prof Lyndell Lim, (c) Viral endophthalmitis management– (i) HSZ, VZV, CMV treatment: Dr Jane Wells, (ii) emerging viral uveitis – Dengue, Zika, Ebola, Chikungunya Dr Genevieve Oliver, (d) Fun- gus – posterior: A/Prof Matthew Simunovic, Scleritis Dr Elsie Chan, (e) Parasitic- toxo which agent/s and how to give it– Dr Dania Qaternah, 3. The next section of the symposium covers practical aspects of prevention and treatment of endophthalmitis. 1. Prevalence and Incidence of post-surgical and IVT related Endophthalmitis (including organisms and sensitivities): A/Prof Penny Allen, 2. Preventing endophthalmitis post cataract surgery and intravitreal injections- review of the best evidence and rec- ommendations. Dr Rohan Merani, Management of post-operative and post injection endophthalmitis
– when to inject and when to perform vitrectomy: Dr Sarah Welch.