# International consensuses and guidelines on diagnosing and managing fungal endophthalmitis by the Asia-Pacific Vitreo-retina Society (APVRS), the Academy of the Asia-Pacific Professors of Ophthalmology (AAPPO), and the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII)

## TL;DR

This paper presents 20 consensus statements from international experts on diagnosing and managing fungal endophthalmitis, addressing key controversies in treatment and diagnosis.

## Contribution

The paper provides the first international consensus guidelines for fungal endophthalmitis management by a multi-society expert panel.

## Key findings

- There is consensus on the importance of early diagnosis and prompt antifungal therapy.
- Disagreements exist regarding the optimal diagnostic methods, timing of vitrectomy, and use of systemic antifungals.
- The role of corticosteroids remains a particularly contested topic among experts.

## Abstract

Fungal endophthalmitis represents one of the most challenging intraocular infections to diagnose and manage in ophthalmology. Despite advances in diagnostic techniques and treatment options, numerous controversies persist regarding optimal approaches to this sight-threatening condition. Due to the low incidence and significant variation in the severity and time of presentations, no large-scale randomized controlled trials have been done. Therefore, identifying controversies and deliberating the best approach to diagnosing and treating fungal endophthalmitis by international experts would help establish consensus statements that can guide clinical practice. The Asia-Pacific Academy of Professors in Ophthalmology (AAPPO), Asia-Pacific Vitreo-Retina Society (APVRS), and Asia-Pacific Society of Ocular Inflammation and Infection (APSOII) saw this critical gap and formed an international panel of experts comprising 24 experts to establish 20 consensus statements. While there is consensus on the need for early diagnosis and prompt administration of antifungal therapy, there are conflicting views on the optimal diagnostic approach to be taken, the role and timing of performing vitrectomy, and the use of systemic antifungal agents. A particularly contested topic is the role of corticosteroids. In establishing the 20 consensus statements, these thus serve as guidelines for diagnosing and managing fungal endophthalmitis.