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Cited by 239Ocular Infections and TreatmentsAntifungal resistance and susceptibilityInfective Endocarditis Diagnosis and Management

Intraocular Candidiasis in Patients with Candidemia

Donahue, Sean P., Greven, Craig M., Zuravleff, Jeffrey J., Eller, Andrew W., Nguyen, M. Hong, Peacock, James E., Wagener, Marilyn M., Yu, Victor L.·1994·Ophthalmology
DOI 10.1016/s0161-6420(94)31175-4
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Abstract

Purpose Intraocular infection caused by Candida species can have devastating visual consequences. With the emergence of Candida as a major nosocomial pathogen, the authors investigated the prevalence of ocular lesions in patients with candidemia and evaluated risk factors for eye involvement.Methods This study is a prospective, multicentered, observational design. One hundred eighteen patients with candidemia were evaluated by the infectious disease service and received indirect ophthalmologic examination within 72 hours of a reported positive blood culture. Ocular findings were classified on the basis of objective, pre-determined criteria. Candida chorioretinitis was defined as the presence of focal, white, infiltrative chorioretinal lesions without vitreal involvement. Candida endophthalmitis was defined as chorioretinitis with extension into the vitreous or intravitreal "fluff balls."Results In contrast to previous studies of patients with candidemia citing prevalence rates of endophthalmitis approaching 40%, no patients were shown to have endophthalmitis. Candida chorioretinitis was seen in 9% of the patients, all of whom received antifungal agents. The observation that chorioretinitis never progressed to endophthalmitis suggests that systemic antifungal agents provided adequate ocular therapy. Risk factors for Candida chorioretinitis include fungemia with Candida albicans (versus nonalbicans species), multiple positive blood cultures, visual symptoms, and immunosuppression. Twenty percent of patients had nonspecific ocular lesions not directly related to infection.Conclusion Patients with candidemia who have the risk factors noted above warrant formal ophthalmologic examination.

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Crossref · 10.1016/s0161-6420(94)31175-4

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  • Metastatic spread of Candida species to the eyes occurs in 9% to 16% of patients with candidemia.

    “Metastatic spread of Candida species to the eyes occurs in 9% to 16% of patients with candidemia [106,107], and may lead to loss of vision.”

    From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [107]

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Authors
Donahue, S. P., Greven, C. M., Zuravleff, J. J., Eller, A. W., Nguyen, M. H., Peacock, J. E., Wagener, M. M., & Yu, V. L.
Affiliations
  • University of Pittsburgh (US)
  • Atrium Health Wake Forest Baptist (US)
  • Duke University (US)
Corresponding author
Yu, Victor L.
ORCID
Venue
Ophthalmology
Publisher
Elsevier BV
Published
1994-07
Volume
101
Issue
7
Pages
1302-1309
ISSN
0161-6420 (ISSN-L)
DOI
10.1016/s0161-6420(94)31175-4
OpenAlex
W16133478
Cited by
239
References
26
Citations by year
2025: 7 · 2024: 3 · 2023: 3 · 2022: 10 · 2021: 8 · 2020: 7 · 2019: 10 · 2018: 8 · 2017: 11 · 2016: 9 · 2015: 11 · 2014: 9 · 2013: 4 · 2012: 7
FWCI
8.59
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
Keywords
candidemia, Candida endophthalmitis, Candida albicans, systemic antifungal therapy, risk factors, immunosuppression
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Antifungal Agents, Candidiasis, Chorioretinitis, Female, Fundus Oculi, Humans, Male, Middle Aged, Prospective Studies, Retina, Risk Factors, Visual Acuity, Eye Infections, Fungal, Prevalence, Fungemia

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