Traumatic endophthalmitis presenting as isolated retinal vasculitis and white-centered hemorrhages: Case report and review of literature

• Main Authors: Nidhi Relhan, Subhadra Jalali, Suma Nalamada, Vivek Dave, Annie Mathai
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2012-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Apoptosis; glaucoma; intraocular pressure; retinal ganglion cells; retinal ischemia; tumor necrosis factor-alpha; Branch retinal vein occlusion; laser; Lucentis; macular edema; Microbial etiology; mucopurulent keratitis; suppurative keratitis; Intraoperative application of mitomycin C; mitomycin C; postoperative complications; preoperative subconjunctival injection; recurrence rate; recurrent pterygium; Cataract; inflammation; mydriasis; prevention and control; surgery; Cross-cylinder technique; photoastigmatic refractive keratectomy; refractive surgery; ′BARC I-125 Ocu-Prosta seeds′; choroidal melanoma; plaque brachytherapy; retinoblastoma; vasoproliferative tumors; Asian Indian; Amaurosis; amaurosis hemianopia; capsulolenticular cataract; conjunctiva; lenticular cataract; leukoma; eye lid; ophthalmia chronica; ophthalmic purulentis; Interpretation; magnetic resonance imaging; orbit; ophthalmology; Antivascular endothelial growth factor; intravitreal bevacizumab; ocular inflammation; Acute macular neuroretinopathy; optical coherence tomography; scotoma; Desferrioxamine; ocular toxicity; optic neuropathy; pigmentary retinopathy; Endophthalmitis; retinal vasculitis; Staphylococcus epidermidis; white-centered retinal hemorrhages
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2012;volume=60;issue=4;spage=317;epage=319;aulast=Relhan
• ISSN: 0301-4738; 1998-3689

The article reports a case and review of the literature of endophthalmitis presenting as isolated retinal vasculitis. A 26-year-old male was observed to have white-centered retinal hemorrhages and retinal vasculitis following an occult scleral perforation. At presentation, the visual acuity was 20/60. With clinical suspicion of early endophthalmitis, he underwent wound exploration, scleral tear repair, vitreous biopsy and administration of intravitreal antibiotics. Microbiology evaluation revealed significant presence of methicillin-resistant coagulase-negative Staphylococcus epidermidis. Final visual acuity improved to 20/20 at 6 weeks postoperatively. Literature search revealed eight similar cases, all of them due to Staphylococcus species. Retinal vasculitis and white-centered retinal hemorrhages can be a presenting sign of early endophthalmitis, especially with non-fulminant pathogens like S. epidermidis.