Subretinal Abscess
Subretinal abscess is a rare manifestation of endogenous bacterial endophthalmitis. It should be investigated in patients with risk factors (eg, intravenous drug use, diabetes, immunosuppression and malignancy) who present with loss of vision and vitreoretinal changes. Early recognition and treatment reduces rates of retinal detachment and improves long-term visual acuity.
Patient 1:
This is a young man with methicillin-resistant Staphylococcus aureus endocarditis of the tricuspid valve. On the third day of hospitalization, mild conjunctival erythema of the right eye was observed, which was associated with discomfort and a subjective decrease in vision. Visual fields on confrontation revealed a large inferior scotoma. Bedside indirect ophthalmoscopy established the presence of a yellow, elevated subretinal mass ∼10 times the diameter of the optic disc, consistent with subretinal abscess. Echocardiography revealed the presence of a right-to-left shunt.
