Cryptococcus neoformans Choroiditis Rupesh Agrawal, Ho Su Ling, Stephen Teoh Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore

46 year old Chinese gentleman. 46 year old Chinese gentleman. Known HIV Known HIV s/p OD: CMV retinitis –treated with intravitreal ganciclovir s/p OD: CMV retinitis –treated with intravitreal ganciclovir OS- presented with blurring of vision OS- presented with blurring of vision Ocular and General History - Case A  LE: Fundus– presence of choroiditis patch superotemporal to fovea

45 year old Chinese gentleman 45 year old Chinese gentleman Known HIV. Known HIV. Sudden onset blurring of vision Sudden onset blurring of vision BCVA – 6/12 OU BCVA – 6/12 OU OD: composite fundus photo OD: composite fundus photo showing presence of hyperemic disc with peripapillary hemmorrhages Ocular and General History - Case B

44 year old Chinese Male. 44 year old Chinese Male. Known HIV Known HIV Acute onset blurring of vision both eyes Acute onset blurring of vision both eyes Both eyes – exudative retinal detachment with hyperemic disc Both eyes – exudative retinal detachment with hyperemic disc Ocular and General History - Case C

 All three patients  C. Neoformans opportunistic infection – positive titres on lumbar puncture at a dilution of 1:256. First Presentation - Investigations

 Cryptococcus induced chorioretinitis with AIDS  based on serology  clinical findings  history (HIV) Diagnosis

 IV Amphotericin: 1mg/kg/day for 7 days  Oral Fluconazole:  800mg OD x 2weeks  400mg OD x 8 weeks  HAART therapy Treatment

Last Follow up – After 6 Months Post Treatment  OD: no active lesions, pallor of disc