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

ABSTRACT

Purpose

To report an atypical case of exogeneous endophthalmitis presenting with Roth spots.

Case

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.

Conclusion

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.

KEYWORDS:

• Exogeneous endophthalmitis
• intravitreal injection
• Roth spots
• staphylococcus
• ultrasonography

Consent

Informed consent was obtained from the patient for this case report.

Disclosure statement

The authors report no conflicts of interest related to this report. Other relationships: Ö. Yanık, None; S. Demirel, Consultant fee, Honorarium for lecturing (Novartis, Bayer, Allergan, Alcon, Baush & Lomb); F. Batıoğlu, Consultant fee, Honorarium for lecturing (Novartis, Bayer, Allergan, Thea); E. Özmert, Consultant fee, Honorarium for lecturing (Novartis, Bayer, Allergan).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.