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Exogenous Fusarium Endophthalmitis: Clinical Features, Treatment Modalities, and Visual Outcomes

Kang S, Smiddy WE, Yannuzzi NA, Albini TA, Miller D, Amescua G, Yoo SH, Flynn HW

Investigative ophthalmology & visual science, 2026

14 participants

Abstract

Purpose: To characterize the clinical features, treatment modalities, and visual outcomes of culture-proven exogenous Fusarium endophthalmitis managed at a tertiary referral center.

Methods: This retrospective, single-center, consecutive case series included 14 eyes of 14 patients with culture-proven exogenous Fusarium endophthalmitis treated between October 2014 and December 2025. Diagnosis was confirmed by positive intraocular (aqueous or vitreous) cultures. Clinical records were reviewed for demographics, presenting characteristics, treatment course, complications, and visual and intraocular pressure outcomes.

Results: Median presenting best-corrected visual acuity (BCVA) was 2.40 logMAR (∼20/5000). Infection sources included trauma (7/14, 50%), anterior segment surgery (5/14, 36%), and contact lens-associated fungal keratitis (2/14, 14%). All eyes required combined antifungal therapy (topical, intravitreal, intracameral, and/or intrastromal with systemic treatment) and surgical intervention, including therapeutic penetrating keratoplasty (14/14, 100%) and vitrectomy (8/14, 57%). Median follow-up was 594 days. Median BCVA at last follow-up remained poor at 2.25 logMAR (∼20/3600), with four of 14 patients (29%) achieving ≥20/400 vision and three of 14 patients (21%) having light perception or no light perception. Complications occurred in 10 of 14 eyes (71%), most commonly ocular hypertension or secondary glaucoma (8/10, 80%) and retinal detachment (3/10, 30%). No eyes…

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 14 participants or records.

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