Do Patients With Candidemia Need an Ophthalmologic Examination?

Area of Science:

• Ophthalmology
• Infectious Diseases
• Medical Research

Background:

• Conflicting recommendations exist regarding screening dilated retinal examinations for patients with candidemia.
• The Infectious Diseases Society of America recommends screening, while the American Academy of Ophthalmology advises against routine screening in asymptomatic patients.

Purpose of the Study:

• To investigate the incidence of ocular complications in patients with candidemia.
• To evaluate the rate of fundoscopic examinations, identify risk factors for ocular complications, and analyze management changes and outcomes.

Main Methods:

• A collaborative study involving infectious diseases and ophthalmology departments.
• Examination of 308 patients diagnosed with candidemia.
• Assessment of fundoscopic examination rates, risk factors, management, and outcomes.

Main Results:

• Presumed Candida chorioretinitis was diagnosed in 6% (9/148) of patients who underwent fundoscopic exams.
• Of those diagnosed, 44% were asymptomatic, and 22% could not report symptoms.
• Ocular candidiasis detection was more sensitive in exams conducted more than seven days after the first positive Candida blood culture.

Conclusions:

• Continued ophthalmological screening for candidemia is considered prudent due to the risk of ocular morbidity.
• A definitive consensus on screening protocols remains challenging due to a lack of outcome data.
• Further research is warranted, and screenings appear more sensitive when performed over seven days post-blood culture.