Mishra Amit V, Loh Graeme K, Ehmann David S
Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia.
Alberta Retina Consultants.
Curr Opin Ophthalmol. 2025 May 1;36(3):161-166. doi: 10.1097/ICU.0000000000001128. Epub 2025 Feb 14.
To examine the role of the ophthalmologist in screening for ocular candidiasis in patients with Candidemia .
Recent evidence has shown that previously published incidence rates of endophthalmitis in Candidemia were overestimating risk due to nonuniform guidelines. Newer data suggest a very low rate of endophthalmitis in the Candidemia population. There is currently a lack of definitive data proving that retinal findings lead to significant changes in the clinical management of patients with regards to systemic treatment and overall outcomes.
Given the low rates of endophthalmitis, minimal management changes with positive retinal findings, and recently published guidelines from the American Academy of Ophthalmology, we posit that ocular screening of all patients with Candidemia is not warranted. However, more research is required to better delineate high-risk features that could guide which patients would require ophthalmologic examination. Further collaboration between ophthalmology and infectious disease specialists is vital to create new evidence-based guidelines based on the recent data.
探讨眼科医生在念珠菌血症患者眼部念珠菌病筛查中的作用。
近期证据表明，由于指南不统一，既往公布的念珠菌血症性眼内炎发病率高估了风险。新数据显示念珠菌血症患者中眼内炎发生率极低。目前缺乏确凿数据证明视网膜检查结果会导致患者全身治疗及总体预后的临床管理发生显著变化。
鉴于眼内炎发生率低、视网膜检查结果呈阳性时管理变化极小，以及美国眼科学会近期发布的指南，我们认为对所有念珠菌血症患者进行眼部筛查并无必要。然而，需要更多研究以更好地界定可指导哪些患者需要眼科检查的高危特征。眼科与传染病专家之间进一步合作对于根据近期数据制定新的循证指南至关重要。
