1. Retinoblastoma


Right answer is 4


Fungal endophthalmitis had been suspected following slit-lamp examination in this patient. Despite a course of treatment with oral and intravitreal voriconazole, the vitreous lesions persisted and a vitrectomy was performed with the findings above. Pathological analysis of the mass revealed a necrotizing granuloma with fungal yeast forms on Gomori methenamine silver staining, a finding consistent with the candida species. After surgery, the visual acuity in the patient’s right eye improved to 20/30, and he completed 6 weeks of oral voriconazole treatment. At the 6-month follow-up visit, his vision was stable and there was no evidence of recurrence.

ref nejm.org