An Atypical Case of Exogeneous Endophthalmitis after Intravitreal Injection Presenting with Roth Spots

• Published in: Ocular immunology and inflammation Vol. 31; no. 5; pp. 1061 - 1067
• Main Authors: Yanık, Özge, Demirel, Sibel, Batıoğlu, Figen, Özmert, Emin
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 28.05.2023
• Subjects: Aged; Anti-Bacterial Agents - therapeutic use; Endophthalmitis - diagnosis; Endophthalmitis - drug therapy; Endophthalmitis - etiology; Exogeneous endophthalmitis; Eye Infections, Bacterial - diagnosis; Eye Infections, Bacterial - drug therapy; Eye Infections, Bacterial - etiology; Humans; intravitreal injection; Intravitreal Injections; Male; Roth spots; staphylococcus; ultrasonography; Vitrectomy - adverse effects; Vitreous Body - microbiology; Exogeneous endophthalmitis; intravitreal injection; Roth spots; ultrasonography; staphylococcus
• ISSN: 0927-3948; 1744-5078
• DOI: 10.1080/09273948.2022.2061525

To report an atypical case of exogeneous endophthalmitis presenting with Roth spots. A 67-year-old man presented with decreased vision, mild pain, and discomfort in his left eye 12 days after an intravitreal aflibercept injection. Best-corrected visual acuity was 20/200, and there were +3 anterior chamber cells. On fundus examination, multiple intraretinal hemorrhages with a central white core resembling a Roth spot were observed. Intravitreal antibiotic injections were performed, and a vitreous sample was taken. Although post-intravitreal injection history was available, full systemic screening was planned to rule out endogenous endophthalmitis because of the presence of these Roth spots. Vitrectomy was performed and methicillin-sensitive coagulase-negative Staphylococcus was detected on culture. Although the presence of Roth spots is an unexpected finding in post-injection endophthalmitis, it was nevertheless demonstrated in our case. For this reason, it should be kept in mind that Roth spots can be encountered in bacterial endophthalmitis.