Abstract
Purpose To determine the incidence of ocular candidiasis and length of ophthalmic follow-up required to rule out ocular candidiasis in candidaemic patients.
Methods We prospectively studied patients with candidaemia at our institution. Eligibility criteria included a dilated ophthalmological examination within 72 h of fungaemia. Patients without ocular candidiasis on initial examination had follow-up dilated ophthalmoscopy performed at 1, 2, 4, 12 and 24 weeks.
Results Between May 1996 and March 1997 a total of 50 patients with fungaemia were identified of whom 31 were included in the study; 15 excluded patients died before an initial examination was performed. The overall incidence of ocular candidiasis was 26% (8/31 patients), all manifested as chorioretinitis. Five patients (16%) had ocular candidiasis on their initial examination. One of 21 patients (5%) without ocular candidiasis on initial examination developed ocular candidiasis within 1 week. Two of 16 patients (13%) without ocular candidiasis on initial examination or at 1 week follow-up developed ocular candidiasis within 2 weeks. No evidence of ocular candidiasis occurred in the 12 patients with follow-up at 4 weeks, the 8 patients with follow-up at 12 weeks and the 4 patients with follow-up at 24 weeks.
Conclusion The incidence of ocular candidiasis among hospitalised patients is clinically significant. We recommend ophthalmological follow-up for development of ocular candidiasis for at least 2 weeks after an initial negative eye examination.
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Dr Krishna is currently affiliated with the University of Missouri-Kansas City, School of Medicine, Department of Ophthalmology/Eye Foundation, Kansas City, Missouri, USA
Presented as a poster at the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, April 1998
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Krishna, R., Amuh, D., Lowder, C. et al. Should all patients with candidaemia have an ophthalmic examination to rule out ocular candidiasis?. Eye 14, 30–34 (2000). https://doi.org/10.1038/eye.2000.7
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DOI: https://doi.org/10.1038/eye.2000.7
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