Visual and anatomical outcome following submacular surgery for choroidal neovascularization secondary to Candida endophthalmitis.
OBJECTIVE
To report the long-term visual and anatomical outcomes for patients treated with submacular surgery for choroidal neovascularization associated with endogenous candidal endophthalmitis.


METHODS
Review of the medical records, fluorescein angiograms, fundus photographs, and histopathologic specimens of patients treated with submacular surgery for choroidal neovascularization following candidal endophthalmitis.


RESULTS
This series included 3 patients (1 woman and 2 men) who were 26, 30, and 60 years of age. Each patient had received systemic antifungal treatment for culture-proven candidal septicemia before the development of choroidal neovascularization. Each patient had bilateral choroidal neovascularization diagnosed by biomicroscopic examination and angiographic appearance: 2 eyes had an active subfoveal membrane; 2, an active juxtafoveal subretinal membrane; and 2, a mixture of active subfoveal neovascularization with subfoveal fibrosis. Submacular surgery was performed on five eyes with choroidal neovascularization; one eye with subfoveal fibrosis was observed. Visual acuity improved substantially in 4 eyes of 3 patients treated with submacular surgery. Visual improvement was limited in the two eyes with preexisting submacular fibrosis. During 13-month to 82-month follow-ups, vision remained stable, with no recurrence of neovascularization.


CONCLUSIONS
Choroidal neovascularization can cause severe visual loss in patients with endogenous candidal infection. Submacular surgery with removal of choroidal neovascularization may restore vision in selected patients. Subfoveal fibrosis may limit visual improvement.
Recchia
Franco M
FM
Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Shah
Guarav K
GK
Eagle
Ralph C
RC
Sivalingam
Arunan
A
Fischer
David H
DH
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000150:complications* / Q000188:drug therapy; D020256:Choroidal Neovascularization / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D009877:Endophthalmitis / Q000150:complications* / Q000188:drug therapy; D015821:Eye Infections, Fungal / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D016469:Fungemia / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008266:Macula Lutea / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010781:Photography; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy
D000935:Antifungal Agents