In Vivo Confocal Microscopy Features In Post COVID19 Fungal Endophthalmitis In Type 2 Diabetes

Abstract Introduction: Corona virus disease-19 (COVID-19) infection with aggressive treatment has resulted in immunosuppression, and co-existing comorbidities that have made patients vulnerable to secondary infections including fungal infections. Purpose: We describe the clinical presentation, various diagnostic methods including in-vivo confocal microscopy features, management and clinical outcomes in Post COVID-19 fungal endophthalmitis in type II diabetics. Methods: Prospective, interventional study on two patients who recovered from COVID-19 who developed endogenous endophthalmitis presented to a tertiary eye care centre in South India. Results: Fungal infection was diagnosed based on clinical features, confocal microscopy, molecular diagnostic methods and culture methods. Two patients were treated with topical, intravitreal and systemic antifungal therapy. Conclusion: We report for the first time two cases of post COVID-19 fungal endophthalmitis in two diabetic patients with confocal features. High index of suspicion, early diagnosis, and appropriate management can improve the visual outcome in post COVID-19 fungal endophthalmitis cases.