Schrader W
Universitäts-Augenklinik, Freiburg.
Fortschr Ophthalmol. 1990;87(4):331-5.
Our records on endogenous Candida endophthalmitis in 13 eyes in 10 patients are presented. The diagnosis was confirmed by culture from vitreous aspirate or serologic examination. The records show that cases with immediate diagnosis and treatment by antimycotics and vitrectomy have a better prognosis than late diagnosis or treatment without vitrectomy. Only the 4 cases that were vitrectomized within 4 weeks after onset of the complaints resulted in good visual acuity (greater than 2/5). The other cases were often complicated by traction, retinal scars or choroidal proliferation. Unclear uveitis with a high risk for fungal infection in the patient's history should be evaluated for Candida infection. Every patient with candidemia needs periodic ophthalmologic examinations for endophthalmitis. Diagnosis, treatment and possible prevention of endogenous Candida endophthalmitis are discussed.
本文呈现了10例患者13只眼的内源性念珠菌性眼内炎记录。诊断通过玻璃体抽吸物培养或血清学检查得以证实。记录显示,早期诊断并采用抗真菌药物及玻璃体切除术治疗的病例,预后优于晚期诊断或未行玻璃体切除术的治疗。仅4例在出现症状后4周内接受玻璃体切除术的患者视力良好(大于2/5)。其他病例常并发牵引、视网膜瘢痕或脉络膜增殖。对于既往有真菌感染高风险的不明葡萄膜炎患者,应评估是否存在念珠菌感染。每位念珠菌血症患者都需要定期进行眼科检查以排查眼内炎。本文还讨论了内源性念珠菌性眼内炎的诊断、治疗及可能的预防措施。