This previously healthy 37YO female presented to us for a second opinion regarding 4 days of decreased vision in her left eye. There was a recent history of a urinary tract infection secondary to E. coli. Vision was 20/20 in her normal OD and 20/400 OS. There was a moderate non-granulomatous uveitis with vitreous cells.
Optos color RG imaging shows opaque white retina in the inferonasal macula with overlying retinal and vitreous blood. An exudative retinal detachment extends inferotemporally with an inferior subretinal hypopyon.
She was referred back to the initially treating ophthalmologist and was subsequently lost to follow-up.
Learning Points:
Posterior segment chorioretinitis from septic embolization is a rare event, most commonly found in patients with bacterial endocarditis. Our patient presented with a constellation of findings, including retinitis, retinal and vitreous hemorrhage, and an exudative retinal detachment with an inferior subretinal hypopyon.
Subretinal hypopyon is characterized by yellowish inflammatory material settling inferiorly in the subretinal space. It has been documented in infectious (bacterial and fungal endophthalmitis, acute retinal necrosis, tuberculosis, syphilis), inflammatory (sympathetic ophthalmia), and neoplastic (leukemia, lymphoma) disorders.
