Bilateral presumed endogenous candida endophthalmitis and stage 3 retinopathy of prematurity

Am J Ophthalmol. 2002 Oct;134(4):611-3. doi: 10.1016/s0002-9394(02)01600-8.

Abstract

Purpose: To report a case of presumed endogenous bilateral Candida endophthalmitis that developed in an infant with bilateral posterior stage 3 retinopathy of prematurity.

Design: Interventional case report.

Methods: In a very low birth weight and extremely premature infant, presumed endogenous bilateral Candida endophthalmitis was successfully eradicated from each eye and retinopathy of prematurity was managed.

Results: Candida endophthalmitis was successfully eradicated from each eye by vitrectomy with instillation of 5 microg amphotericin B. Stage 3 retinopathy of prematurity without "plus disease" in the right eye regressed without ablation of the avascular peripheral retina. Stage 3 retinopathy with "plus disease" in the left eye was successfully managed with endolaser photocoagulation.

Conclusions: Concomitant Candida endophthalmitis and posterior stage 3 retinopathy of prematurity often portend a dismal prognosis. We describe an infant for whom prompt diagnosis and aggressive therapy of both conditions resulted in a favorable anatomic outcome in both eyes.

MeSH terms

  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use
  • Candidiasis* / therapy
  • Endophthalmitis / complications*
  • Endophthalmitis / microbiology*
  • Fundus Oculi
  • Humans
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Infant, Premature*
  • Retinopathy of Prematurity / complications*
  • Retinopathy of Prematurity / pathology
  • Treatment Outcome
  • Vitrectomy

Substances

  • Antifungal Agents
  • Amphotericin B