Multimodal imaging of refractory Candida chorioretinitis progressing to endogenous endophthalmitis.

Mihai Mititelu // Publications // Dec 01 2015

PubMed ID: 26253239

Author(s): Lavine JA, Mititelu M. Multimodal imaging of refractory Candida chorioretinitis progressing to endogenous endophthalmitis. J Ophthalmic Inflamm Infect. 2015 Dec;5(1):54. doi: 10.1186/s12348-015-0054-z. Epub 2015 Aug 8. PMID 26253239

Journal: Journal Of Ophthalmic Inflammation And Infection, Volume 5, Issue 1, Dec 2015

BACKGROUND Endogenous fungal endophthalmitis is a serious vision-threatening condition that occurs in immunosuppressed patients with candidemia.

FINDINGS We report a complicated case of Candida albicans chorioretinitis that progressed to endophthalmitis. The patient required intravitreal and systemic anti-fungal medications with pars plana vitrectomy for successful treatment. Multimodal imaging using fundus photography, fluorescein angiography, spectral domain optical coherence tomography, and fundus autofluorescence was obtained throughout treatment. These modalities localized the Candida infection in the choroid, penetrating Bruch’s membrane, the retinal pigment epithelium, and the retina to enter the vitreous cavity. This infectious route resulted in loss of the retinal pigment epithelium, photoreceptors, and outer retinal layers, with scar formation that resulted in vision loss and increased future risk of choroidal neovascular membranes.

CONCLUSIONS Multimodal imaging of C. albicans chorioretinitis allows for accurate diagnosis, assessment of response to therapy, and prognosis for visual recovery and future complications.