[Ophthalmoscopic surveillance in treated patients with invasive Candida disease].
BACKGROUND
Invasive Candida disease (ICD) is the most common cause of endogenous endophthalmitis. There are two characteristic ocular signs: Candida chorioretinitis defined as retina and choroid lesions without vitreal involvement, and Candida endophthalmitis defined as chorioretinitis with extension into the vitreous with characteristic fluffy balls. The most common visual symptoms are blurred vision and floaters.


OBJECTIVE
To define in which patients with ICD a surveillance ophthalmoscopic examination should be done.


METHODS
We searched the PubMed/Medline data base Candida endophthalmitis in adult and paediatric patients with ICD.


CONCLUSIONS
The need of ophthalmoscopic examination in patients with ICD is controversial, partly due to the fact that early antifungal treatment leads to a significant decrease of endogenous Candida endophthalmitis. Routine ophthalmoscopic examination seems of little value in patients with positive blood culture, with early implementation of antifungal treatment, without symptoms of ocular infection and without impairment of the level of consciousness during the episode. However, ophthalmoscopic examination should be performed in children with candidemia and critically ill patients with documented ICD, in the second week of treatment, especially in echinocandin treatment.
Pérez-Blázquez
Eugenio
E
Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, España. epblazquez@mi.madritel.es
D000328:Adult; D002177:Candidiasis / Q000150:complications* / Q000453:epidemiology; D002648:Child; D002825:Chorioretinitis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D016638:Critical Illness; D009877:Endophthalmitis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D016469:Fungemia / Q000150:complications* / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications; D009887:Ophthalmoscopy; D015995:Prevalence