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Published byJulian Andrews Modified over 8 years ago
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Ocular Candidiasis Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom
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Ocular History 73, male, British complaints of blurred vision no pain, redness
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General History prolonged hospitalisation for systemic co-morbid conditions diabetes, hypertension
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First Presentation - Fundus VA: OD: 6/9, OS- CF @ 3ft OD: retinal exudates OS: vitreous haze with retinochoroidal lesion and pigmenatry changes
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Immediate Investigation intravitreal tap – for gram stain, fungus intravitreal tap – for gram stain, fungus candida – positive candida – positive
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Diagnosis bilateral candida endophthalmitis with vitritis based on clinical findings co-morbid conditions with prolonged hospitalisation positive vitreous biopsy
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Treatment systemic Amphotericin B (5mg/kg intravenously for 14 days) systemic Amphotericin B (5mg/kg intravenously for 14 days) vitreous tap with intravitreal injection of Amphotericin B (0.1ml of 10ug/ml – stat and was repeated after 48 hours vitreous tap with intravitreal injection of Amphotericin B (0.1ml of 10ug/ml – stat and was repeated after 48 hours
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Follow-up - After six months lesions completely resolved VA recovered to 6/6 in OU
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Final follow up – After 12 Months anti fungal treatment for six weeks OU: cataract surgery, no specific pre- or postoperative treatment VA: 6/6 – OU no AC cells, no flare, no fundus lesions
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