Ocular lesions in disseminated candidiasis

To assess the prevalence and patterns of ocular involvement in disseminated candidiasis in intensive care setting.

Institutional review board approved case review of intensive care admissions. These were patients of septicemia who had undergone ocular examination as part of their initial assessment. The records of patients in whom Candida spp. was detected in two sites or had a clinical diagnosis of candidemia were analyzed.

Twelve patients (nine male, three female) were diagnosed with candida-induced sepsis during this period. Their ages ranged from 26 to 97 years (mean 52.7 years). Six patients (50%) had ocular lesions. The commonest lesion was chorioretinitis, seen in seven eyes of six patients followed by Roth spots seen in one eye. There was no evidence of vitritis or endophthalmitis in any eye. Systemic immunosuppression was present in three of six (50%) patients with ocular changes. Incidental findings included two eyes with non-proliferative diabetic retinopathy.

Any suspicion of disseminated candidiasis should prompt an ocular evaluation which may help in the early diagnosis and in the institution of early antifungal therapy. This may reduce ocular morbidity and patient morbidity.