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Neonatal candidiasis: ophthalmologic infection

Jill E Baley1, Forrest J Ellis

  • 1Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH 44106-6010, USA. jxb13@po.cwru.edu

Seminars in Perinatology
|November 25, 2003
PubMed

Insights

Ocular candidiasis in preterm infants can lead to endophthalmitis, a serious eye infection. Early antifungal treatment is crucial for preventing vision loss in infants with candidemia.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Infectious Diseases

Background:

  • Endophthalmitis in preterm infants is a severe complication of systemic candidiasis.
  • While early systemic antifungal therapy reduces ocular involvement, it still occurs in approximately 6% of cases.
  • Prolonged candidemia increases the risk of eye disease, which can manifest early or later in infancy.

Purpose of the Study:

  • To review the presentation, diagnosis, and management of endophthalmitis in preterm infants with candidiasis.
  • To highlight the role of Candida species in neonatal eye infections.
  • To discuss the impact of candidemia on retinopathy of prematurity.

Main Methods:

  • Review of clinical presentations and diagnostic findings.
  • Ophthalmoscopic examination for characteristic retinal and vitreal lesions.
  • Assessment of treatment outcomes with systemic antifungal therapy and surgical interventions.

Main Results:

  • Characteristic findings include unilateral or bilateral yellow-white retinal/vitreal lesions with hemorrhage and vitreous haze.
  • Systemic antifungal therapy is often effective, but some cases require lensectomy for persistent or recurrent infections, especially lens abscesses.
  • Candidemia is associated with the progression of retinopathy of prematurity.

Conclusions:

  • Prompt diagnosis and systemic antifungal treatment are vital for preserving vision in preterm infants with ocular candidiasis.
  • Ocular complications, such as lens abscesses, may necessitate surgical intervention.
  • The link between candidemia and retinopathy of prematurity progression warrants further investigation.

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