Subretinal Aspergillus Abscess in Post COVID-19 Recovered Patients - An Emerging Problem

Ocul Immunol Inflamm. 2023 Jan;31(1):127-133. doi: 10.1080/09273948.2021.1993271. Epub 2021 Nov 16.

Abstract

Purpose: To describe endogenous endophthalmitis in the setting of Covid-19 pneumonia post recovery.

Methods: Retrospective review of five patients of endogenous endophthalmitis following Covid-19 disease done.

Results: All five cases had received systemic corticosteroid for a mean duration of 7 days during severe Covid-19 treatment. Decrease vision was presenting symptom between 1 and 31 days following Covid-19 recovery. All patients had presumed fungal endogenous endophthalmitis based on clinical profile. Four out of five patients subjected to pars plana vitrectomy had microbiologically proven aspergillus species endogenous endophthalmitis on vitreous fluid assessment; two cases each of aspergillus niger and aspergillus fumigates. Four eyes underwent pars plana vitrectomy with silicone oil injection had shown satisfactory anatomical outcome with control of the infection; however, no significant visual gain achieved.

Conclusion: We reported five cases of aspergillus endogenous endophthalmitis in Covid-19 recovered patients to document the likely presentation of this rising entity and avoid misdiagnosis.

Keywords: Covid-19 disease; Fungal endogenous endophthalmitis; aspergillus fumigatus; aspergillus niger; intravitreal voriconazole; retinal pseudohypopyon; subretinal abscess.

MeSH terms

  • Abscess / diagnosis
  • Abscess / drug therapy
  • Abscess / etiology
  • Aspergillosis* / diagnosis
  • Aspergillosis* / drug therapy
  • Aspergillosis* / microbiology
  • Aspergillus
  • COVID-19 Drug Treatment
  • COVID-19* / complications
  • Endophthalmitis* / diagnosis
  • Endophthalmitis* / drug therapy
  • Endophthalmitis* / etiology
  • Eye Infections, Fungal* / diagnosis
  • Eye Infections, Fungal* / drug therapy
  • Eye Infections, Fungal* / microbiology
  • Humans
  • Retrospective Studies
  • Vitrectomy