University of Pittsburgh Medical Center, Division of Infectious Diseases, Pittsburgh, PA, USA.
Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA.
Clin Infect Dis. 2022 Sep 29;75(6):1092-1096. doi: 10.1093/cid/ciac233.
Ocular candidiasis (OC) complicates approximately 10% of candidemia and carries potentially severe morbidity. There are conflicting recommendations about the need for routine funduscopic examinations of candidemic patients. Indirect funduscopy is accurate and safe in diagnosing OC, and positive findings change recommended treatment. However, conclusive evidence that treatment changes improve outcomes is lacking. Bringing perspectives as infectious diseases physicians and ophthalmologists, we review controversies about OC and endorse routine screening during candidemia. We acknowledge difficulties in obtaining inpatient ophthalmologic consults and recommend studies to evaluate digital fundus photography and teleophthalmology as an alternative to funduscopic examinations by ophthalmologists in asymptomatic patients.
眼念珠菌病（OC）约占念珠菌血症的 10%，具有潜在的严重发病率。关于是否需要对念珠菌血症患者进行常规眼底检查，存在相互矛盾的建议。间接眼底镜检查在诊断 OC 方面准确且安全，阳性结果可改变推荐的治疗方案。然而，缺乏确凿的证据表明治疗改变可改善结局。作为传染病医生和眼科医生，我们回顾了 OC 的争议，并支持在念珠菌血症期间进行常规筛查。我们承认在获得住院眼科会诊方面存在困难，并建议进行研究，以评估数字眼底摄影和远程眼科作为替代无症状患者眼科医生进行眼底检查的方法。
