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Is routine ophthalmoscopy really necessary in candidemic patients?

2017; Public Library of Science; Volume: 12; Issue: 10 Linguagem: Inglês

10.1371/journal.pone.0183485

1932-6203

Antonio Vena, Patricia Muñóz, Belén Padilla, Maricela Valerio, María Isabel Torres Sánchez, Mireia Puig‐Asensio, Jesús Fortün, Mario Fernández‐Ruiz, Paloma Merino, Juan Emilio Losa, Ana Loza, R.A. Rivas, Emilio Bouza,

Antifungal resistance and susceptibility

The purpose of this study was to determine among patients with candidemia the real rate of ophthalmoscopy and the impact of performing ocular assessment on the outcome of the disease. We performed a post hoc analysis of a prospective, multicenter, population-based candidemia surveillance program implemented in Spain during 2010–2011 (CANDIPOP). Ophthalmoscopy was performed in only 168 of the 365 patients with candidemia (46%). Ocular lesions related to candidemia were found in only 13/168 patients (7.7%), of whom 1 reported ocular symptoms (incidence of symptomatic disease in the whole population, 0.27% [1/365]). Ophthalmological findings led to a change in antifungal therapy in only 5.9% of cases (10/168), and performance of the test was not related to a better outcome. Ocular candidiasis was not associated with a worse outcome and progressed favorably in all but 1 evaluable patient, who did not experience vision loss. The low frequency of ophthalmoscopy and ocular involvement and the asymptomatic nature of ocular candidiasis, with a favorable outcome in almost all cases, lead us to reconsider the need for systematic ophthalmoscopy in all candidemic patients.