DOI: 10.1097/IAE.0b013e3181e799a7
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Issn Print: 0275-004X
Publication Date: 2010/09/01
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Excerpt
We are grateful for the comments by Dr. Behera et al regarding our photo essay. They present a patient with subacute postoperative endophthalmitis with vitreous and preretinal opacities that appear similar to the lesions presented in our recent photo essay.1 In their patient, as in our patient, vitreous specimens were culture negative. No optical coherence tomography was provided in their report. Because these white multifocal lesions were seen before injection of antibiotics, the authors conclude that the fundus findings may represent preretinal inflammatory opacities or “exudates.”
The posterior segment image presented by the authors likely represents intravitreal opacities seen commonly in endophthalmitis. The authors suggest that these deposits may represent periphlebitis or “exudates on the retinal surface [found] during pars plana vitrectomy.” The lesions seen in both cases, however, are clearly not perivascular. In our patient, the lesions were localized by optical coherence tomography to the surface of the retina and did not involve intraretinal exudation. We have seen patients with new white preretinal lesions in the posterior pole after vancomycin and ceftazidime injection. Furthermore, the lesions in our patient were not identified before antibiotic injection, albeit through hazy media. The discussion highlights the utility of optical coherence tomography in better defining the location of preretinal lesions, that is, posterior vitreous opacities versus preretinal antibiotic aggregates.
