Lavine Jeremy A, Mititelu Mihai
Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, 2870 University Avenue, Room 206, Madison, WI, 53705, USA,
J Ophthalmic Inflamm Infect. 2015 Dec;5(1):54. doi: 10.1186/s12348-015-0054-z. Epub 2015 Aug 8.
Endogenous fungal endophthalmitis is a serious vision-threatening condition that occurs in immunosuppressed patients with candidemia.
We report a complicated case of Candida albicans chorioretinitis that progressed to endophthalmitis. The patient required intravitreal and systemic anti-fungal medications with pars plana vitrectomy for successful treatment. Multimodal imaging using fundus photography, fluorescein angiography, spectral domain optical coherence tomography, and fundus autofluorescence was obtained throughout treatment. These modalities localized the Candida infection in the choroid, penetrating Bruch's membrane, the retinal pigment epithelium, and the retina to enter the vitreous cavity. This infectious route resulted in loss of the retinal pigment epithelium, photoreceptors, and outer retinal layers, with scar formation that resulted in vision loss and increased future risk of choroidal neovascular membranes.
Multimodal imaging of C. albicans chorioretinitis allows for accurate diagnosis, assessment of response to therapy, and prognosis for visual recovery and future complications.
内源性真菌性眼内炎是一种发生在念珠菌血症免疫抑制患者中的严重视力威胁性疾病。
我们报告了一例进展为眼内炎的白色念珠菌脉络膜视网膜炎复杂病例。患者需要玻璃体内及全身抗真菌药物治疗，并联合行玻璃体切割术才能成功治愈。在整个治疗过程中，采用了眼底照相、荧光素血管造影、光谱域光学相干断层扫描和眼底自发荧光等多模态成像技术。这些检查方法确定了念珠菌感染位于脉络膜，穿透布鲁赫膜、视网膜色素上皮和视网膜进入玻璃体腔。这种感染途径导致视网膜色素上皮、光感受器和视网膜外层丧失，形成瘢痕，导致视力丧失，并增加了未来脉络膜新生血管膜的风险。
白色念珠菌脉络膜视网膜炎的多模态成像有助于准确诊断、评估治疗反应以及预测视力恢复和未来并发症情况。
