Endogenous endophthalmitis is an ophthalmic emergency that can have severe sight-threatening complications. It is often a diagnostic challenge because it can manifest at any age and is associated with a number of underlying predisposing factors. Microorganisms associated with this condition vary along a broad spectrum. Depending upon the severity of the disease, both medical and surgical interventions may be employed. Due to rarity of the disease, there are no guidelines in literature for optimal management of these patients. In this review, treatment guidelines based on clinical data and microorganism profile have been proposed.

Purpose: To report the imaging characteristics of acute Vogt–Koyanagi–Harada (VKH) disease using optical coherence tomography angiography (OCTA). Methods: In this prospective study, patients with acute VKH (n = 10; mean age: 30.5 ± 13.43 years) underwent multimodal imaging (baseline and follow-up) using fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA), OCT, and OCTA. The OCTA images were analyzed to assess the retinochoroidal vasculature and compared with other imaging techniques. Results: During the active stage, all eyes showed multiple foci of choriocapillaris flow void that correlated with ICGA. These foci decreased in number and size after initiation of therapy. In one patient, flow void areas reappeared after cessation of therapy without any detectable change on ICGA. This patient soon developed clinical recurrence requiring re-initiation of immunosuppression. Conclusions: OCTA allows high-resolution imaging of inflammatory foci suggestive of choriocapillaris hypoperfusion in acute VKH disease non-invasively. OCTA may be very helpful in the follow-up of such patients.

Purpose: To standardize a nomenclature system for defining clinical phenotypes, and outcome measures for reporting clinical and research data in patients with ocular tuberculosis (OTB). Methods: Uveitis experts initially administered and further deliberated the survey in an open meeting to determine and propose the preferred nomenclature for terms related to the OTB, terms describing the clinical phenotypes and treatment and reporting outcomes. Results: The group of experts reached a consensus on terming uveitis attributable to tuberculosis (TB) as tubercular uveitis. The working group introduced a SUN-compatible nomenclature that also defines disease “remission” and “cure”, both of which are relevant for reporting treatment outcomes. Conclusion: A consensus nomenclature system has been adopted by a large group of international uveitis experts for OTB. The working group recommends the use of standardized nomenclature to prevent ambiguity in communication and to achieve the goal of spreading awareness of this blinding uveitis entity.

Aims To compare optical coherence tomography (OCT) features of active necrotising infectious retinitis (NIR) due to toxoplasmosis or herpesviruses and to determine distinctive OCT signs for these two causes of infectious retinitis. Methods OCT scans from eyes with active NIR due to varicella zoster virus (VZV), herpes simplex virus (HSV), cytomegalovirus (CMV), and toxoplasmosis (TOXO) were reviewed. All images were evaluated for the presence of previously described OCT findings in TOXO-NIR and compared with the viral group. New OCT findings were recorded and compared. Retinal and choroidal thickness were measured at the site of NIR and compared. Results 10 eyes diagnosed with TOXO-NIR and 13 eyes affected by viral-NIR (9 CMV and 4 VZV) were analysed. All eyes showed full thickness hyper-reflectivity, disruption of the retina and a variable degree of vitritis. Among previously described OCT signs, hyper-reflective oval deposits and hypo-reflectivity of the choroid had a higher prevalence in TOXO (p=0.018 and p<0.0001, respectively). Among the new signs, hyper-reflective round deposits along the posterior hyaloid, retrohyaloid hyper-reflective spots and a disruption of the choroidal architecture were more frequent in TOXO eyes (all p<0.01). Intra-retinal oedema and hyper-reflective vertical strips within the outer nuclear layer were suggestive of a viral aetiology (p=0.045). Retinal thickness at the site of NIR did not differ between the two groups. Choroidal thickness was significantly higher in TOXO eyes (p=0.01). Conclusions The diagnosis of NIR is largely based on clinical and laboratory findings. OCT changes may be useful in differentiating different causes of NIR.

Purpose: To report epidemiology of uveitis in a tertiary-care referral institute in North India. Methods: Hospital records of patients with uveitis between June 2011 and September 2014 were retrospectively analyzed. Results: Of the 1912 patients, 56.64% were males. Anterior uveitis (43.04%) was the most common manifestation followed by posterior uveitis (24.58%), panuveitis (16.21%), and intermediate uveitis (10.66%). Specific etiologies could be ascertained in 60.56%. Tuberculosis (22.9%) was the most common infectious and HLA-B27-associated uveitis (9.46%) among non-infectious causes. Conclusions: There is a trend towards a decrease in idiopathic etiologies of uveitis. Tuberculosis remains the most common infectious etiology in North India.

Purpose: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. Methods: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. Results: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. Conclusions: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.