Purpose: To assess, as one part of systemic management, the needs for a fundus examination of patients with candidemia to accommodate the possibility of endogenous fungal endophthalmitis.
Patients and methods: We reviewed retrospectively the medical records of in-patients diagnosed with candidemia between January 2003 and September 2009 at Niigata Cancer Center Hospital. Thirty seven patients were found. We attempted to make a survey of the physicians in charge of the patients' candidemia regarding the management of fungal endophthalmitis.
Results: Thirteen (24.5%) doctors answered that they had ordered an ophthalmologic consultation for all the patients with candidemia either with or without eye symptoms. However, 31 (58.5%) doctors referred only the patients with eye symptoms to an ophthalmologist. Among the six (16.2%) patients who underwent ophthalmic examination, only one patient had chorioretinitis consistent with early stages of endogenous fungal endophthalmitis, and that completely resolved with systemic treatments.
Conclusions: Not all patients with candidemia need to receive ophthalmologic evaluations routinely wherever adequate antifungal therapies can be performed, although fully dilated optic fundus examination is important for all candidemic patients who have visual symptoms. It is, however, necessary to educate all physicians about endogenous fungal endophthalmitis.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 116: 476-484, 2012.