Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy.
Save Sight Institute, Sydney Hospital and Sydney Eye Hospital, University of Sydney, Sydney, New South Wales, Australia.
Retina. 2018 May;38(5):1011-1018. doi: 10.1097/IAE.0000000000001630.
To describe vitreal, retinal, and choroidal features of eyes affected by Endogenous candida endophthalmitis (ECE) analyzed by spectral domain optical coherence tomography (SD-OCT) and to evaluate their clinical impact.
Medical records and SD-OCT images from eyes diagnosed with ECE at four retina and uveitis tertiary referral centers were retrospectively evaluated. Spectral domain optical coherence tomography images were analyzed to evaluate the structural changes occurring in the vitreous, the retina, and the choroid in areas involved by ECE. Baseline and final best-corrected visual acuity were correlated with SD-OCT findings.
Fifteen eyes from nine patients were enrolled. Vitreous involvement (vitreous cells, posterior hyaloid thickening) was detected in 13/15 eyes. Peculiar hyper-reflective preretinal aggregates obscuring the underlying retina because of a shadowing effect ("rain-cloud" sign) were noticed in all eyes with vitreous involvement. Two patterns of retinal and choroidal findings were identified: the first (six eyes) confined within the inner retinal layers (Intraretinal Pattern), the second (nine eyes) involving both retina (full thickness) and choriocapillaris (Chorioretinal Pattern). None of the eyes showed both patterns. None of the eyes, regardless the pattern, showed choroidal thickening. Baseline best-corrected visual acuity was not associated with OCT pattern (P = 0.09). On the contrary, final best-corrected visual acuity was significantly higher in patients showing Intraretinal Pattern (∼20/25, 0.06 ± 0.08 LogMAR) than in subjects with Chorioretinal Pattern (∼20/50, 0.44 ± 0.30 LogMAR) (P = 0.01).
Endogenous candida endophthalmitis showed peculiar features on SD-OCT. Two distinct patterns of chorioretinal involvement influencing the final best-corrected visual acuity were identified. Spectral domain optical coherence tomography could be useful in the diagnosis, management, and outcome prediction in ECE.
描述通过谱域光相干断层扫描（SD-OCT）分析受内源性念珠菌眼内炎（ECE）影响的眼睛的玻璃体、视网膜和脉络膜特征，并评估其临床影响。
回顾性分析了四家视网膜和葡萄膜炎三级转诊中心诊断为 ECE 的患者的病历和 SD-OCT 图像。分析谱域光相干断层扫描图像，以评估 ECE 受累区域的玻璃体、视网膜和脉络膜的结构变化。将基线和最终最佳矫正视力与 SD-OCT 结果相关联。
纳入了 9 名患者的 15 只眼。15 只眼中的 13 只眼存在玻璃体受累（玻璃体细胞、后玻璃体增厚）。所有存在玻璃体受累的眼中均可见到一种独特的高反射性视网膜前聚集体，由于阴影效应而使下方视网膜模糊（“雨云”征）。发现了两种视网膜和脉络膜表现模式：第一种（6 只眼）局限于内视网膜层（视网膜内模式），第二种（9 只眼）累及视网膜（全层）和脉络膜毛细血管（脉络膜视网膜模式）。没有一只眼同时表现出两种模式。无论表现模式如何，均未出现脉络膜增厚。基线最佳矫正视力与 OCT 模式无关（P=0.09）。相反，表现为视网膜内模式的患者的最终最佳矫正视力明显更高（约 20/25，0.06±0.08 LogMAR），而表现为脉络膜视网膜模式的患者则更低（约 20/50，0.44±0.30 LogMAR）（P=0.01）。
内源性念珠菌眼内炎在 SD-OCT 上具有独特的特征。确定了两种不同的脉络膜视网膜受累模式，影响最终最佳矫正视力。谱域光相干断层扫描可用于 ECE 的诊断、管理和预后预测。
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