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Title	Different presentations of ophtalmic aspergillosis
Abstract Nr.	P02

Purpose	To describe three patients with different ophthalmic lesions due to aspergillus.
Methods	Case reports
Results	The first patient was treated with methylprednisolone (MPS) for autoimmune hepatitis. She complained of blurred vision in her right eye and had a uveitis with hypopyon. General work-up revealed pulmonary and brain lesions suggestive of aspergillosis. Immunologic testing was positive for aspergillus. Her general status degraded rapidly and she died despite antimycotic therapy. The second patient had a history of sarcoïdosis and developed a right hemicranial pain with vision loss and optic nerve oedema. An orbital lesion was demonstrated by CT scan and was unresponsive to MPS. A biopsy was performed and showed aspergillus fumigatus. The lesion responded poorly to different antimycotic therapies, invaded the chiasma and the patient lost her visual acuity till no light perception. The third patient was treated with high doses MPS for GVHD. She presented for acute bilateral visual loss. Visual acuity was no light perception in both eyes. There was a strong anterior chamber inflammation and the fundus was hardly visible. A systemic work-up demonstrated pulmonary and brain lesions and a positive immunologic test for aspergillus. Vitreous specimen showed the presence of aspergillus. No visual acuity could be saved despite intense antimycotic treatment. Few months after, the patient died.
Conclusion	Our cases illustrate that ophthalmic aspergillosis can present acutely with a devastating intraocular inflammation or more indolently in the setting of sino-orbital aspergillosis. Both forms have a bad visual prognosis and the systemic one is frequently associated with a fatal outcome.

Author 1

Last name	WILLERMAIN
Initials	F
Department	CHU St-Pierre
City	Bruxelles

Author 2

Last name	Bradstreet
Initials	C
Department	CHU St-Pierre
City	Bruxelles

Author 3

Last name	Kampouridis
Initials	S
Department	CHU St-Pierre
City	Bruxelles

Author 4

Last name	Libert
Initials	J
Department	CHU St-Pierre
City	Bruxelles

Author 5

Last name	Koch
Initials	P
Department	CHU St-Pierre
City	Bruxelles

Author 6

Last name	Caspers
Initials	L
Department	CHU St-Pierre
City	Bruxelles