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ENDOPHTHALMITIS PRESENTING AS RETINAL VASCULITIS LESS THAN 24 HOURS AFTER AFLIBERCEPT INJECTION: A CASE REPORT
Jessica E Weinstein1, Margaret A Greven
1Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Purpose:
We describe a case of endophthalmitis caused by Streptococcus salivarius presenting as a retinal vasculitis less than 24 hours after intravitreal injection.
Methods:
A case report.
Results:
The patient progressed from a hemorrhagic retinal vasculitis to severe endophthalmitis with no view to the posterior segment within 24 hours. The visual acuity progressed from 20 of 20 preinjection to light perception within less than 48 after injection. Vitreous tap and injection was performed within 24 hours of intravitreal aflibercept injection, followed by pars plana vitrectomy the next day. The final visual acuity was hand motions.
Conclusion:
Streptococcus salivarius is a virulent organism that may cause an endophthalmitis early after intravitreal injection with an unusual presentation of hemorrhagic retinal vasculitis. A high index of suspicion for infectious endophthalmitis should be maintained for all patients presenting with ocular inflammation and worsening vision in the days after intravitreal injections.
