Fibrinous nodular anterior segment membrane as a presentation of chronic postoperative Aspergillus endophthalmitis

Abstract

A 63-year-old lady, with over-the-counter steroid use, presented with a gradual progressive diminution of vision 6 months after uncomplicated cataract surgery. On examination, the vision was hand movements and the anterior chamber (AC) showed a thick, irregular fibrinous membrane over the iris and pupil and a fixed hypopyon, and B-scan revealed vitritis. AC membrane and vitreous biopsy was done along with intracameral and intravitreal Amphotericin-B. Owing to the poor response and microbiological tests suggestive of Aspergillus, core vitrectomy with intravitreal Voriconazole injection was done. Significant improvement in vision and inflammation was noted, after 1 month. Fungal etiology must be suspected in the presentation of endophthalmitis as a fibrinous and nodular membrane, and all such patients must be reviewed for systemic immunosuppression.