Endophthalmitis Caused by Curtobacterium pusillum Following Open Globe Injury

Purpose: To report the first case of Curtobacterium endophthalmitis within 6 hours after open globe injury, with extensive phlebitis and secondary subretinal neovascularization. Case summary: A 53-year-old man with hypersensitivity to beta-lactam antibiotics was admitted due to visual disturbance in the left eye experienced while working in a rural area. Fundus examination was impossible due to a full-layer corneal laceration and traumatic cataract in the left eye. B-scan ultrasonography and orbital computed tomography showed no shadowing of retained intraocular foreign bodies. After a corneal scraping smear, primary closure, lensectomy, and vitrectomy were performed. Organic material was observed in a focal area of pale macula, accompanied by extensive retinal phlebitis in the mid-periphery. After diagnosing acute bacterial endophthalmitis, intravitreal vancomycin and dexamethasone were injected. Curtobacterium pusillum was cultured on an automated microbial identification system. Intravenous vancomycin and oral clarithromycin were administered for 2 weeks. After 3 months, endophthalmitis had not recurred, and the visual acuity reached 20/100. However, subretinal neovascularization was newly detected under the damaged macula. No complications of neovascularization were observed until 6 months after primary closure. Conclusions: Curtobacterium pusillum can induce acute endophthalmitis through direct penetration in cases of ocular trauma, and may be accompanied by extensive phlebitis and secondary subretinal neovascularization. In cases of open globe injury sustained in rural areas, acute endophthalmitis caused by a rare Gram-positive bacillus, such as Curtobacterium species, should be considered.

Current classification of macular neovascularization in the course of AMD based on the Consensus Nomenclature for Reporting Neovascular Age-Related Macular Degeneration Data

Despite the improvement of diagnostic and therapeutic techniques age-related macular degeneration is still one of the main causes of central vision impairment. Throughout the years, the classification of subretinal neovascularization in the course of age-related macular degeneration has changed due to the advancement of diagnostic and therapeutic techniques. In 2020 an expert panel reached consensus on a new nomenclature for neovascularization in the course of age-related macular degeneration introducing the concept of macular neovascularization, which refers to each neovascularization in macula, regardless of the location.

Long-Term Outcomes in Macular Telangiectasia Type 2 With Subretinal Neovascularization

Purpose: This work reports long-term outcomes in macular telangiectasia type 2 (MacTel) with subretinal neovascularization (SRNV). Methods: A retrospective, single-center review of medical records was performed on all patients with a diagnosis of MacTel presenting between May 2004 and October 2019. Medical and ocular history, best-corrected visual acuity (BCVA) at baseline and final visit, optical coherence tomography data, and treatment history of SRNV secondary to MacTel were recorded. Results: A total of 471 eyes were diagnosed with MacTel. SRNV was present in 44 eyes (9.3%), of which 38 eyes met inclusion criteria for SRNV. Average follow-up duration in the SRNV group was 78.4 months. All SRNV patients underwent antivascular endothelial growth factor (anti-VEGF) therapy. There was no significant change from mean baseline (0.59 ± 0.45) to final (0.70 ± 0.49) BCVA in the SRNV group as a whole ( P = .13). Subgroup analysis revealed 17 of 38 eyes had SRNV at diagnosis and received immediate anti-VEGF treatment. In this subgroup mean pretreatment BCVA was 0.89 ± 0.43 and the mean final BCVA was 0.87 ± 0.61 ( P = .84). The remainder (21 of 38 eyes) developed SRNV during follow-up. In this subgroup, final BCVA after initiation of treatment was 0.56 ± 0.32, an improvement in BCVA from SRNV onset ( P = .04) and a decrease from pre-SRNV onset baseline BCVA ( P = .008). Conclusions: Visual acuity is maintained, not improved, in long-term follow-up of MacTel with SRNV treated with anti-VEGF. Patients presenting with SRNV have a worse prognosis than those who develop SRNV during follow-up.