Factors determining visual outcome in endogenous Candida endophthalmitis.
OBJECTIVE
To determine factors affecting the visual outcome of eyes with endogenous Candida endophthalmitis.


METHODS
Retrospective cohort study of 44 eyes from 36 patients diagnosed with candida endophthalmitis at 2 tertiary referral uveitis centers. Outcome measures included the development of retinal detachment and the occurrence of visual loss (visual acuity of <20/40) and severe visual loss (visual acuity of ≤ 20/200).


RESULTS
Twenty four of 44 eyes (55%) had visual loss and 16 of 44 eyes (32%) had severe visual loss by the end of the study. Early vitrectomy significantly reduced the risk of retinal detachment (P = 0.02). Factors associated with poor visual outcome included poor presenting visual acuity (relative risk = 2.38; 95% confidence interval, 1.01-5.55; P < 0.05) and centrally located fungal lesions (relative risk = 5.01; 95% confidence interval, 1.00-2.52; P < 0.05).


CONCLUSIONS
Candida endophthalmitis is associated with a high rate of visual loss, particularly in patients with poor presenting visual acuity or centrally located lesions. Early vitrectomy reduces the risk of retinal detachment.
Moorfields Eye Hospital, London, UK.
Ahmed
A
Sallam
Simon R J
SR
Taylor
Aldrin
A
Khan
Peter
P
McCluskey
William A
WA
Lynn
Kiran
K
Manku
Patricio A
PA
Pacheco
Sue
S
Lightman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000302:isolation & purification*; D009877:Endophthalmitis / Q000382:microbiology* / Q000601:surgery; D015821:Eye Infections, Fungal / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy