Endogenous Fungal Endophthalmitis: Causative Organisms, Management Strategies, and Visual Acuity Outcomes

• Published in: American journal of ophthalmology Vol. 153; no. 1; pp. 162 - 166.e1
• Main Authors: Lingappan, Ahila, Wykoff, Charles C, Albini, Thomas A, Miller, Darlene, Pathengay, Avinash, Davis, Janet L, Flynn, Harry W
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2012; Elsevier; Elsevier Limited
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Aged; Aged, 80 and over; AIDS; Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Cardiovascular disease; Child; Child, Preschool; Colleges & universities; Coronary vessels; Endophthalmitis - microbiology; Endophthalmitis - physiopathology; Endophthalmitis - therapy; Eye Infections, Fungal - microbiology; Eye Infections, Fungal - physiopathology; Eye Infections, Fungal - therapy; Female; Follow-Up Studies; Fungi - isolation & purification; Health Insurance Portability & Accountability Act 1996-US; HIV; Hospitalization; Human immunodeficiency virus; Humans; Infant; Infections; Male; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Organisms; Retrospective Studies; Risk Factors; Substance abuse treatment; Testing laboratories; Treatment Outcome; Visual Acuity - physiology; Vitrectomy; Eye disease; Organism; Clinical management; Endogenous; Prognosis; Visual acuity; Evolution; Strategy; Uvea disease; Ophthalmology; Endophtalmitis
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2011.06.020

Purpose To report the causative organisms, management strategies, and visual outcomes in endogenous fungal endophthalmitis. Design Observational case series. Methods Microbiologic and medical records were reviewed retrospectively for all patients with culture-positive endogenous fungal endophthalmitis between January 1, 1990, and July 1, 2009. Results Study criteria were met in 65 eyes of 51 patients with mean follow-up of 18 months. Yeasts were the most common causative organism in 38 (75%) patients compared with molds in 13 (25%) patients. Retinal detachment occurred in 17 eyes (26%). Visual acuity of 20/200 or better was present in 28 (56%) eyes with yeasts and in 5 (33%) eyes with molds at the last follow-up. Conclusions Yeasts were the most common cause of culture-proven unilateral or bilateral endogenous fungal endophthalmitis. Endogenous fungal endophthalmitis generally is associated with poor visual acuity outcomes, especially when caused by molds. Retinal detachment is a frequent occurrence during follow-up.