American Journal of Ophthalmology Case Reports最新文献

{"title":"Pyrenochaeta unguis-hominis-associated fungal keratitis: A rare case report with in vivo confocal microscopy findings","authors":"Andreas Guttmann,&nbsp;Paul Wintersteller,&nbsp;Nora Woltsche,&nbsp;Astrid Heidinger,&nbsp;Nika Medic Ajdnik,&nbsp;Karin Pekovits,&nbsp;Ingrid Boldin,&nbsp;Haleh Aminfar,&nbsp;Jutta Horwath-Winter","doi":"10.1016/j.ajoc.2025.102373","DOIUrl":"10.1016/j.ajoc.2025.102373","url":null,"abstract":"<div><h3>Purpose</h3><div>Pyrenochaeta unguis-hominis, also known as Neocucurbitaria unguis-hominis, is a rare fungal pathogen typically isolated from skin and nail infections. Recently, it has been identified as a cause of fungal keratitis, particularly among contact lens wearers. This case report documents the occurrence of Pyrenochaeta unguis-hominis keratitis in Austria and the visualization of changes in the corneal stroma using in vivo confocal microscopy (IVCM).</div></div><div><h3>Observations</h3><div>A 48-year-old female patient presented with severe photophobia and acute pain in her left eye, following extended wear of soft contact lenses. Initial examination revealed a central corneal infiltrate. IVCM was performed prior to corneal scraping, which was then sent for direct staining, culture, and next-generation sequencing (NGS) and identified Pyrenochaeta unguis-hominis and Streptococcus oralis. Treatment included hourly topical voriconazole 2 %, natamycin 5 % and vancomycin 2.5 %, with additional epithelial debridement to enhance drug penetration. IVCM imaging allowed for real-time visualization and tracking of structures with the appearance of fungal hyphae, guiding the treatment course. Over several months, IVCM demonstrated a reduction in these structures, and the patient's condition stabilized, resulting in improved corneal clarity and Best Corrected Distance Visual Acuity from 0.8 to 0.9 (Snellen decimal scale).</div></div><div><h3>Conclusions and importance</h3><div>This case contributes to the limited clinical literature on Pyrenochaeta unguis-hominis-associated keratitis and includes IVCM imaging of a cornea with this rare infection. While IVCM provided early, non-invasive visualization of stromal changes, definitive diagnosis was achieved through molecular testing. A conservative treatment regimen with topical antifungals and epithelial debridement was effective, emphasizing the importance of rapid diagnostics and targeted therapy in managing rare corneal infections.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102373"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed-onset Moraxella nonliquefaciens endophthalmitis following intravitreal injection","authors":"Paul S. Micevych,&nbsp;Monika Fleckenstein,&nbsp;Paul S. Bernstein","doi":"10.1016/j.ajoc.2025.102370","DOIUrl":"10.1016/j.ajoc.2025.102370","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a case of <em>Moraxella nonliquefaciens</em> endophthalmitis presenting one month after intravitreal injection.</div></div><div><h3>Observations</h3><div>An 84-year-old man presented to the retina clinic with vision loss, pain, and redness in his right eye 28 days after a routine intravitreal injection of faricimab for exudative age-related macular degeneration. The patient had a remote history of cataract surgery, rhegmatogenous retinal detachment repair, and scleral buckle explant for exposure 3 years prior. The patient was found to have endophthalmitis, characterized by a hypopyon and dense vitritis. Broad-spectrum intravitreal antimicrobials and dexamethasone were administered, and a vitreous tap returned sterile. The patient achieved initial quiescence, but he had two recurrences of inflammation in this eye over the next 4.5 months. The patient ultimately underwent pars plana vitrectomy, vitreous biopsy, intraocular lens explant, capsulectomy and repeat intravitreal antimicrobial injections for definitive treatment. Broad-range PCR testing detected <em>Moraxella nonliquefaciens</em>. Inflammation resolved after surgery without further recurrence in the subsequent 7-month post-operative period.</div></div><div><h3>Conclusions and importance</h3><div><em>Moraxella</em> species have been implicated in cases of endophthalmitis associated with glaucoma filtering surgery and trauma, but this report details a delayed-onset <em>Moraxella nonliquefaciens-</em>associated endophthalmitis after intravitreal injection.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102370"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal pseudomicrocysts following claudin-6 antibody-drug conjugate infusion","authors":"Laura Matuszewska ,&nbsp;Caitlynn Cooper ,&nbsp;Victoria Sattarova ,&nbsp;Wassef Chanbour ,&nbsp;Evan Meyer ,&nbsp;Vania Rashidi","doi":"10.1016/j.ajoc.2025.102375","DOIUrl":"10.1016/j.ajoc.2025.102375","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a case of bilateral corneal pseudomicrocysts associated with infusions of a novel antibody-drug conjugate targeting claudin-6, called TORL-1-23.</div></div><div><h3>Observations</h3><div>A 47-year-old female with a history of advanced recurrent serous ovarian cancer presented to a level 1 tertiary care center with ocular irritation, redness, tearing, and light sensitivity following two infusions of TORL-1-23. Patient's past ocular history was unremarkable. The patient was enrolled in a phase 1 clinical trial for TORL-1-23, an antibody-drug conjugate (ADC). Nine days following the second infusion the patient presented to the ophthalmology clinic complaining of two weeks of bilateral eye discomfort, tearing, and photophobia. On examination, the patient had decreased visual acuity with a surface keratopathy associated with a whorled pattern of epithelial pseudomicrocysts in both eyes. Corneal changes were concentrated between the inferior limbus and central cornea. The remainder of the ophthalmic exam was unremarkable. Collagen and silicone punctal plugs were placed and the patient was started on preservative free artificial tears, topical loteprednol 0.5 %, later replaced with topical prednisolone acetate 1 % drops, and brimonidine 0.2 % in both eyes. The patient developed neuropathy which necessitated a decrease in ADC dosage and the patient's symptoms subsequently improved. However, a decrease in visual acuity and increase in corneal pseudomicrocysts was seen after the fifth infusion. Corneal disease improved with the placement of new collagen punctal plugs and addition of cyclosporine 0.05 % eye drops in both eyes. Ocular symptoms and exam findings waxed and waned with continued infusions of the ADC.</div></div><div><h3>Conclusions and importance</h3><div>This case reports an incidence of corneal pseudomicrocysts associated with TORL-1-23 treatment, which should be recognized as a potential adverse effect of this novel therapy.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102375"},"PeriodicalIF":0.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal widefield OCT optic nerve thickness measurements in a case of incipient non-arteritic ischemic optic neuropathy","authors":"Winston Z. Lam ,&nbsp;Mengxi Shen ,&nbsp;Qinqin Zhang ,&nbsp;Viet Hoan Le ,&nbsp;Konica Singla ,&nbsp;Marjan Imani Fooladi ,&nbsp;Hong Jiang ,&nbsp;Byron L. Lam ,&nbsp;Ruikang K. Wang ,&nbsp;Giovanni Gregori ,&nbsp;Philip J. Rosenfeld","doi":"10.1016/j.ajoc.2025.102367","DOIUrl":"10.1016/j.ajoc.2025.102367","url":null,"abstract":"<div><h3>Purpose</h3><div>Widefield swept-source optical coherence tomography angiography (SS-OCTA) scans were combined with a semi-automated algorithm for the early detection and resolution of optic nerve edema in a case of incipient non-arteritic anterior ischemic optic neuropathy (NAION).</div></div><div><h3>Observations</h3><div>An incidental case of incipient NAION was identified in a 71-year-old woman enrolled in an ongoing prospective SS-OCTA imaging study using 12 × 12 mm scans that allowed imaging of both the macular and optic disc regions of patients with age-related macular degeneration (AMD). Early intervention with systemic corticosteroids led to the resolution of optic disc edema without subsequent vision loss. A novel semi-automated algorithm was used to quantify the onset and resolution of optic nerve edema and edema in the surrounding retina.</div></div><div><h3>Conclusions and importance</h3><div>This use of 12 × 12 mm SS-OCTA scans and a semi-automated algorithm can significantly improve the detection and management of incipient NAION in clinical practice with the possibility that early detection would facilitate earlier intervention and better vision preservation in this condition. The use of widefield OCT imaging in conjunction with this novel algorithm in eyes at risk for optic nerve and macular edema could have broader implications for other retinal diseases in which optic disc and macular edema might arise such as diabetic retinopathy. Integrating this methodology into routine ophthalmic evaluations will enable clinicians to identify the onset of edema prior to vision loss, thereby improving patient outcomes.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102367"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of hematocornea with intraocular neoplasm","authors":"Oganes Georgievich Oganesyan ,&nbsp;Daria Alexandrovna Gusak ,&nbsp;Svetlana Vladimirovna Saakyan ,&nbsp;Anush Gamletovna Amiryan ,&nbsp;Sergey Victorovich Milash ,&nbsp;Carolina Oganesyan","doi":"10.1016/j.ajoc.2025.102372","DOIUrl":"10.1016/j.ajoc.2025.102372","url":null,"abstract":"<div><h3>Purpose</h3><div>Herein, we report a rare case of recurrent hematocornea due to a non-pigmented adenoma of the ciliary body and its successful management with repeated deep anterior lamellar keratoplasty (DALK).</div></div><div><h3>Observations</h3><div>A 27-year-old man presented with significant visual acuity loss in his only functional eye due to hematocornea. Initial management involved visco-DALK, which restored visual acuity to 0.8. After 6 months, recurrent hematocornea prompted the removal of the underlying neoplasm through a scleral approach, which was histologically confirmed as a non-pigmented adenoma of the ciliary body. A repeat DALK was performed, followed by phacoemulsification with intraocular lens implantation for subsequent cataract development. Postoperative recovery was uneventful, and visual acuity stabilized at 0.8.</div></div><div><h3>Conclusions and importance</h3><div>This case highlights the feasibility and efficacy of visco-DALK in managing hematocornea while preserving endothelial integrity. The approach facilitated subsequent interventions, including neoplasm excision, repeat DALK, and cataract surgery, with favorable visual outcomes.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102372"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of choroidal solitary fibrous tumor with extraocular extension and subsequent postoperative rhegmatogenous retinal detachment","authors":"Takashi Baba ,&nbsp;Kosuke Furuta ,&nbsp;Shin-ichi Sasaki ,&nbsp;Satoshi Kuwamoto ,&nbsp;Hisashi Suyama ,&nbsp;Dai Miyazaki","doi":"10.1016/j.ajoc.2025.102366","DOIUrl":"10.1016/j.ajoc.2025.102366","url":null,"abstract":"<div><h3>Purpose</h3><div>Extraocular extension of a solitary fibrous tumor (SFT) in the choroid is rare, and few reports describe cases in which the eye is preserved and monitored postoperatively. This report details the management of an SFT with extraocular invasion complicated by postoperative rhegmatogenous retinal detachment (RRD).</div></div><div><h3>Observations</h3><div>A 57-year-old woman presented with painless eyelid swelling. Imaging revealed a choroidal mass infiltrating the extraocular tissues. Partial surgical excision was performed after the patient refused enucleation without a tissue diagnosis. Histopathological and immunohistochemical analyses confirmed the diagnosis of SFT. Postoperatively, the patient developed RRD due to acute posterior vitreous detachment. Pars plana vitrectomy was successfully performed to address the RRD. Despite residual tumor within the eye and extraocularly, no tumor progression was observed during six months of follow-up. Visual function remained stable.</div></div><div><h3>Conclusions/importance</h3><div>This case highlights the clinical challenges posed by choroidal SFTs with extraocular extension. This case underscores the importance of vigilant postoperative monitoring for complications such as RRD. Regular follow-up is crucial to assess tumor stability, manage potential complications, and maintain visual function in patients with residual disease.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102366"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anemic retinopathy as the presenting symptom of a mediastinal germ cell tumor","authors":"Christian Tallo ,&nbsp;Paul Farris ,&nbsp;Edmund Farris","doi":"10.1016/j.ajoc.2025.102374","DOIUrl":"10.1016/j.ajoc.2025.102374","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe a rare case of anemic retinopathy as the initial presenting symptom of a mediastinal germ cell tumor.</div></div><div><h3>Observations</h3><div>A 27-year-old male with no prior medical history presented with a one-day history of central vision loss in his left eye. Funduscopic evaluation showed a central macular hemorrhage in the left eye and bilateral nerve fiber layer hemorrhages and blot hemorrhages. Fluorescein angiography showed multiple hemorrhages without vascular occlusion or neovascularization, features indicative of anemic retinopathy. Laboratory evaluation demonstrated severe anemia (hemoglobin 6.7 g/dL), with an otherwise unremarkable metabolic and coagulation profile. Given these findings, an underlying hematologic or oncologic disorder was suspected, prompting further systemic evaluation. Imaging revealed a large anterior mediastinal mass, and biopsy confirmed a nonseminomatous germ cell tumor. The patient underwent chemotherapy with cisplatin, etoposide, and bleomycin, later transitioning to VIP (ifosfamide, etoposide, and cisplatin) due to suspected pulmonary toxicity. Patient responded well to treatment; his anemia gradually improved, and alpha-fetoprotein levels significantly declined. Following treatment, the patient reported no ongoing visual disturbances.</div></div><div><h3>Conclusions and importance</h3><div>Anemic retinopathy can be the initial presentation of an underlying malignancy. Recognizing ophthalmologic findings as potential indicators of systemic disease is critical for early diagnosis and timely intervention in cases of occult malignancies.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102374"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cobalt-induced Retinopathy: Unveiling the hidden risk of knee prosthesis","authors":"Aim-On Saengsirinavin ,&nbsp;Jia-Horung Hung ,&nbsp;Anadi Khatri ,&nbsp;Celine Dan-Tam Nguyen ,&nbsp;Pamok Seangsirinavin ,&nbsp;Frances Andrea Anover ,&nbsp;Negin Yavari ,&nbsp;Dalia El-feky ,&nbsp;Ngoc Trong Tuong Than ,&nbsp;Osama Elaraby ,&nbsp;Xiaoyan Zhang ,&nbsp;Anh Ngoc Tram Tran ,&nbsp;Cigdem Yasar ,&nbsp;Azadeh Mobasserian ,&nbsp;Irmak Karaca ,&nbsp;Amir Akhavanrezayat ,&nbsp;Chi Mong Christopher Or ,&nbsp;Quan Dong Nguyen","doi":"10.1016/j.ajoc.2025.102369","DOIUrl":"10.1016/j.ajoc.2025.102369","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a case of cobalt-induced retinopathy from a knee prosthesis and to outline the diagnostic challenges and management approach.</div></div><div><h3>Observation</h3><div>A 67-year-old female presented with chronic bilateral visual disturbances, including blurred vision and photopsia, which began shortly after receiving a cobalt-containing knee prosthesis (DePuy Sigma Total Knee System, recalled by FDA in 2014, Recall No. Z-0423-2014). Ophthalmic evaluation revealed bilateral chorioretinitis, cystoid macular edema, and optic disc inflammation. Removal of the cobalt-containing prosthesis, along with aggressive immunosuppressive therapy, led to significant improvement in visual acuity and retinal function, as confirmed by fluorescein angiography, electroretinography, and Goldmann visual field testing.</div></div><div><h3>Conclusion</h3><div>This case adds to the limited literature on cobalt-induced retinopathy by demonstrating that even small prosthetic implants, such as knee prostheses, can lead to systemic cobalt toxicity with significant ocular complications. Early diagnosis, combined with prompt removal of the affected prosthesis and management of inflammation, is crucial for restoring vision and preventing further damage.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102369"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rose bengal photodynamic antimicrobial therapy combined with amniotic membrane graft for the management of infectious keratitis in a patient with keratoprosthesis","authors":"Ruth Eskenazi-Betech,&nbsp;Guillermo Raul Vera-Duarte,&nbsp;Ana P. Murillo-López,&nbsp;Aldo Hernandez-Hernandez,&nbsp;Arturo Ramirez-Miranda,&nbsp;Alejandro Navas,&nbsp;Enrique O. Graue-Hernandez","doi":"10.1016/j.ajoc.2025.102365","DOIUrl":"10.1016/j.ajoc.2025.102365","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the use of Rose Bengal Photodynamic Antimicrobial Therapy (RB-PDAT) combined with amniotic membrane graft (AMG) as a novel surgical technique for infectious keratitis in a patient with Boston Keratoprosthesis (B-Kpro) type 1 Lucia.</div></div><div><h3>Methods</h3><div>A 91-year-old woman with a history of B-Kpro type 1 Lucia implantation in both eyes presented for routine follow-up complaining of pain and redness in the left eye. Slit-lamp examination revealed a 6 mm corneal infiltrate with an epithelial defect adjacent to the optic stem. After 2 weeks of topical antimicrobial therapy without any improvement, the decision was made to perform RB-PDAT in conjunction with an AMG. The infectious keratitis resolved within 21 days.</div></div><div><h3>Conclusions</h3><div>The combination of RB-PDAT and AMG may be considered as a surgical alternative in patients with keratoprosthesis complicated by severe infectious keratitis refractory to standard medical treatment.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102365"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presumed bilateral endogenous Cryptococcus neoformans endophthalmitis with concomitant Toxoplasma gondii retinochoroiditis","authors":"Shane Griffin ,&nbsp;Neeraj Chawla ,&nbsp;Lawrence Chan ,&nbsp;Anita Agarwal ,&nbsp;Gaurav Shah","doi":"10.1016/j.ajoc.2025.102364","DOIUrl":"10.1016/j.ajoc.2025.102364","url":null,"abstract":"<div><h3>Purpose</h3><div>To report a case of bilateral endogenous <em>Cryptococcus</em> endophthalmitis with <em>Toxoplasma</em> retinochoroiditis.</div></div><div><h3>Observations</h3><div>A 57-year-old woman with history of renal transplantation developed <em>Cryptococcus neoformans</em> fungemia and meningitis. Reporting bilateral blurry vision, she was found to have associated bilateral endophthalmitis suspicious for endogenous cryptococcal endophthalmitis that was initially responsive to intravitreal voriconazole injections but subsequently worsened despite systemic and intraocular anti-fungal treatments. Given her refractory disease, additional testing was performed, which revealed added infection with <em>Toxoplasma gondii</em>. She underwent bilateral vitrectomy with povidone-iodine infusion and systemic parasiticidal treatment with improvement and stability of her condition.</div></div><div><h3>Conclusions and importance</h3><div>Immunocompromised hosts are at risk for infection with multiple opportunistic infections that may require broad testing and aggressive medical and surgical therapies.</div></div>","PeriodicalId":7569,"journal":{"name":"American Journal of Ophthalmology Case Reports","volume":"39 ","pages":"Article 102364"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}