Affiliation:
1. Department of Vitreoretina, Rajan Eye Care Hospital, Chennai, Tamil Nadu, India
Abstract
To report a case of acute postoperative endophthalmitis that was complicated by macular infarction following intravitreal liposomal amphotericin B injection. A 76-year-old was diagnosed with acute endophthalmitis after uneventful phacoemulsification surgery and underwent pars plana vitrectomy with intravitreal antifungal (voriconazole). We switched to liposomal amphotericin B (5 µg/0.1 mL) from voriconazole in view of non-resolving exudates post vitrectomy. A few hours later, the patient complained of decreased vision, and fundus examination revealed an extensive area of macular infarction. The patient was continued on oral antifungal, and vitreal lavage with intravitreal dexamethasone was done. Optical coherence tomography angiography (OCT-A) at 6 months follow-up showed improved perfusion in the ischemic area, and the patient maintained a visual acuity of 20/80. Retinal toxicity can be a complication while treating post-vitrectomy patients with intravitreal amphotericin B. Early intervention may help in preserving vision by improving vascular perfusion at the macula.