Asymmetric retinopathy of prematurity in presumed fungal endophthalmitis

Hasenin Al-khersan, Nimesh A. Patel, Kenneth C. Fan, Thomas A. Lazzarini, Nicolas A. Yannuzzi, Brenda Fallas, Catherin Negron, Audina M. Berrocal

Research output: Contribution to journalArticle

Abstract

Purpose: To report a case of asymmetric retinopathy of prematurity (ROP) in a neonate with endophthalmitis. Observations: A 25-week old female was born by caesarean section due to preeclampsia. The patient required supplemental oxygen after birth. The neonatal period was complicated by sepsis secondary to necrotizing enterocolitis with intestinal perforation. The patient subsequently developed endophthalmitis in the right eye. A fungal ball was seen overlying the termination of a persistent hyaloid artery. The patient also had ROP, identified at 31 weeks postconceptional age, which progressed asymmetrically and demonstrated greater severity in the eye affected by endophthalmitis. The endophthalmitis resolved with intravitreal antifungal treatment and systemic therapy. The right eye was also treated with intravitreal bevacizumab, demonstrating regression of ROP severity on follow up. Conclusions and Importance: The present case describes the first reported case of asymmetric ROP associated with endophthalmitis. The more severe ROP occurred in the eye with endophthalmitis suggesting that, outside of systemic factors, the local ocular inflammatory environment is important in determining the progression of ROP. Additionally, the fungal ball present in the eye affected by endophthalmitis was seen at the termination of the hyaloid artery, suggesting the hyaloid artery as the route of entry of the fungus into the vitreous.

Original languageEnglish (US)
Article number100722
JournalAmerican Journal of Ophthalmology Case Reports
Volume18
DOIs
StatePublished - Jun 2020

Keywords

  • Endophthalmitis
  • Pediatric retina
  • Retina
  • Retinopathy of prematurity

ASJC Scopus subject areas

  • Ophthalmology

Fingerprint Dive into the research topics of 'Asymmetric retinopathy of prematurity in presumed fungal endophthalmitis'. Together they form a unique fingerprint.

  • Cite this

    Al-khersan, H., Patel, N. A., Fan, K. C., Lazzarini, T. A., Yannuzzi, N. A., Fallas, B., Negron, C., & Berrocal, A. M. (2020). Asymmetric retinopathy of prematurity in presumed fungal endophthalmitis. American Journal of Ophthalmology Case Reports, 18, [100722]. https://doi.org/10.1016/j.ajoc.2020.100722