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Purpose: To describe the role of optical coherence tomography (OCT) in detecting subclinical choroidal inflammation and early diagnosis of macular complications in chronic Vogt-Koyanagi-Harada (VKH) disease with sunset glow fundus., Methods: Retrospective observational study. Clinical features, OCT images, treatment, and visual outcome were analyzed., Results: Fourteen patients (9 females and 5 males) were included in the study. Mean age was 39 years (range 7-67 years). Mean duration of disease was 5.25 years (range 1-15 years). Anterior uveitis was seen in 14 eyes (52%). Fundus examination showed sunset glow fundus in all patients with no obvious macular pathology. OCT showed macular edema in 16 eyes (59%), choroidal neovascular membrane in 8 eyes (30%), and macular hole in 3 eyes (11%)., Conclusion: OCT should be regularly used to detect subclinical inflammation and early macular complications in chronic VKH disease where sunset glow fundus may delay the clinical diagnosis thus causing permanent damage.

Aim : To analyze the incidence, microbiological profile, risk factors, and outcomes in eyes with osteo-odonto keratoprosthesis (OOKP) developing endophthalmitis. Methods & material : Retrospective review of medical records of patients presenting between 2003 and 2013 with OOKP and endophthalmitis was undertaken after obtaining IRB approval. Patient demographics, clinical features, microbiological evaluation, treatment details, and outcomes were analyzed. Results : Of 92 eyes with OOKP, 8 (9%) had endophthalmitis. Indications for OOKP included Steven-Johnson syndrome (SJS; n = 6; 75%) and chemical injuries (n = 2; 25%). The mean duration from OOKP surgery to endophthalmitis was 49.4 ± 32.3 months. Seven of eight eyes had associated laminar resorption. Endophthalmitis resolved with conservative management in three eyes. Lamina removal was required in three eyes; one eye underwent evisceration. At presentation, mean BCVA was 2.76 ± 0.24 logMAR that improved to 2.48 ± 1.0 logMAR after intervention. Mean follow-up was 12.6 ± 13.2 months. Conclusion : Endophthalmitis portends a grave prognosis for eyes with OOKP. The most important risk factors are SJS (75%) and lamina resorption (88%).

Purpose : To describe a case of presumed ocular toxoplasmosis. Method : A retrospective chart review. Result : This case report describes a 35-year-old male who presented hypopyon anterior uveitis in his left eye. Fundus examination revealed severe vitritis which precluded the view of retina. His serum anti-toxoplasma immunoglobulin (Ig)G was significantly raised, with a normal anti-toxoplasma IgM level and PCR from nested primers targeting B1 gene of Toxoplasma gondii was positive. He was started on empirical anti-toxoplasma therapy. Undiluted vitreous specimen collected during lensectomy and diagnostic vitrectomy in left eye was also positive for nested primers targeting B1 gene of T. gondii. Conclusion : Ocular toxoplasmosis without retinochoroiditis, though extremely rare, can occur.

Purpose: To report early confirmation of Mycobacterium tuberculosis (MTB) endophthalmitis by detection of 85B mRNA in vitreous by a reverse transcriptase polymerase chain reaction (RT-PCR) technique., Methods: Retrospective, interventional case series of 5 patients with MTB endogenous endophthalmitis. Vitreous aspirate was subjected to Ziehl-Neelsen (ZN) staining, BACTEC MicroMGIT culture, RT-PCR targeting the 85B gene, real-time PCR targeting the IS6110 region, and nested PCR targeting the MPB64 gene and IS6110 region. Correlation between detection of MTB RNA, culture positivity, and ZN staining was studied., Results: Five patients with endophthalmitis with no history of tuberculosis revealed acid-fast bacilli on ZN staining of vitreous. RT-PCR detected 85B RNA within 24 h. Culture for MTB was positive in 3/5 patients after 1 month. None of the eyes recovered any useful vision., Conclusions: RT-PCR can detect viable MTB RNA and provide evidence of active infection much earlier than culture.

Purpose: To report Enterococcus faecalis endophthalmitis (EFE) in children and its comparison with adults., Methods: Retrospective study of 19 children up to 18 years age, undergoing vitrectomy for EFE at a referral eye center from January 1995 to December 2015. The results were compared to 18 adults with EFE., Results: The mean age was 7.4 ± 3.06 years. Post-traumatic EFE was seen in 17 (89.4%) children (p < 0.05) versus postoperative EFE seen in 12 (66%) adults. Broomstick 9 (52.9%) and hypodermic needle injury 6 (35.2%) were common associations. "Optimum functional outcome" was achieved in 12 (63.1%) eyes of children and 5 (27.7%) eyes of adults (p = 0.03). Sealed and Zone II wounds, lens, and needle injuries had good outcome whereas intervention after 3 days and retinal detachment had poor outcomes (p < 0.05). The was no correlation with the Ocular Trauma Score., Conclusion: EFE in children is rare; seen with broom stick and needle injuries, if managed early recovers optimum vision.