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Updated: Jul 30, 2026
Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
Published on: December 28, 2017
No evidence of increased ocular involvement in candidemic patients initially treated with echinocandins
1Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
Abstract:
Candins are commonly used as initial therapy in patients with candidemia and are known to diffuse poorly into ocular tissue. The aim of our multicenter study was to assess whether eye involvement was more common in patients initially treated with echinocandins. We performed a post hoc analysis of a prospective, multicenter, population-based candidemic surveillance program implemented in Spain during 2010-2011 (CANDIPOP project). Eye involvement was detected in 13 of 168 patients with candidemia (7.7%) who underwent ophthalmoscopy. Two patients had endophthalmitis, while the remaining patients had chorioretinitis. The frequency of ocular candidiasis was similar in patients receiving initial therapy with candins (3/56; 5.4%) or with other regimens (10/112; 8.9%). At multivariate analysis, risk conditions for eye involvement were dialysis after candidemia (OR, 19.4; 95% CI, 1.7-218.4) and involvement of organs other than the eye (OR, 5.4; 95% CI, 1.1-25.7). In conclusion, eye involvement was not found to be more frequent in patients receiving initial therapy with echinocandins than in patients receiving other drugs.
Insights
Initial echinocandin therapy for candidemia did not increase eye involvement risk. Ocular candidiasis occurred in 7.7% of patients, with similar rates between echinocandin and other treatment groups.
Area of Science:
- Infectious Diseases
- Ophthalmology
- Pharmacology
Background:
- Echinocandins are standard initial therapy for candidemia.
- Limited ocular penetration of echinocandins raises concerns about efficacy in preventing eye involvement.
- Ocular candidiasis can lead to severe vision impairment.
Purpose of the Study:
- To determine if initial echinocandin therapy increases the frequency of eye involvement in patients with candidemia.
- To identify risk factors associated with ocular candidiasis in candidemia patients.
Main Methods:
- Post hoc analysis of a prospective, multicenter, population-based candidemic surveillance program (CANDIPOP project).
- Ophthalmoscopy performed on 168 patients with candidemia.
- Multivariate analysis to assess risk factors for eye involvement.
Main Results:
- Eye involvement was detected in 7.7% (13/168) of patients with candidemia.
- The frequency of ocular candidiasis was similar between patients initially treated with echinocandins (5.4%) and those treated with other regimens (8.9%).
- Independent risk factors for eye involvement included dialysis post-candidemia and non-ocular organ involvement.
Conclusions:
- Initial therapy with echinocandins does not appear to increase the risk of eye involvement in patients with candidemia.
- Dialysis and multi-organ involvement are significant risk factors for ocular candidiasis.
