Postoperative Cataract Endophthalmitis Masquerading as Hemorrhagic Occlusive Retinal Vasculitis (HORV): A Case Report

ABSTRACT

Purpose: To report a case of postoperative cataract bacterial endophthalmitis masquerading as hemorrhagic occlusive retinal vasculitis (HORV).

Case Report: A 69-year-old female presents following uncomplicated cataract surgery of her right eye with new onset floaters, aching pain, decreased visual acuity, increased intraocular pressure, deep anterior chamber reaction, vitritis, and retinal vascular sheathing with diffuse blot hemorrhages. The majority of these clinical symptoms are commonly seen in bacterial endophthalmitis with exception to the retinal findings, which point to possible diagnosis of HORV, a recently described, largely untreatable phenomena associated with intracameral vancomycin use during surgery. After careful investigation and examination, our patient was successfully treated with pars plana vitrectomy and intravitreal antibiotics.

Conclusion: This case report describes the unusual case of a postoperative bacterial endophthalmitis presenting with characteristic signs of HORV, a largely untreatable, exceedingly rare phenomena that commonly results in poor visual acuity.

Keywords:

• Acute retinal necrosis
• bacterial endophthalmitis
• cataract surgery
• Hemorrhagic occlusive retinal vasculitis
• Staphylococcus epidermidis

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.