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Endogenous endophthalmitis with iridolenticular involvement - a case report and systematic review

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Teoh R. J. J., Lai Y. P., Alias R., Nor Azita A. T., Choo S. Y.

OphthaTherapy

2023

vol. 10

issue 4

253-260

Endogenous endophthalmitis (EE) is a sight- and life-threatening disease. EE associated with the involvement of iris and crystalline lens is an uncommon presentation. We reported a case of EE with iridolenticular involvement in a 19-year-old woman with a history of candidemia. Therapeutic vitrectomy with lensectomy was performed, and the patient was treated with intravitreal meropenem and amphotericin B. She was discharged with 6 weeks of oral fluconazole. At follow-up, her vision was 20/60 with aphakic correction. We also conducted a systematic review of the current literature to analyse the clinical features, risk factors, and outcomes of EE with iridolenticular involvement. The systematic review included 10 cases, and found that Candida albicans was the main causative organism. Intravenous drug use and a history of invasive procedures were important risk factors. 70% of the cases required vitrectomy and lensectomy. Post treatment, majority of the cases (80%) had a good visual prognosis of better than 20/60. Our results suggested that in cases of EE with iridolenticular involvement, early surgical removal of the infectious nidus via vitrectomy and lensectomy is recommended for a good visual outcome. A high level of suspicion is crucial in diagnosing the disease, and early aggressive therapy is fundamental.

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1 OphthaTherapy

1 2023

1 Alias R.

1 Choo S. Y.

1 Lai Y. P.

1 Nor Azita A. T.

1 Teoh R. J. J.

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Endogenous endophthalmitis with iridolenticular involvement - a case report and systematic review