Is routine ophthalmoscopy really necessary in candidemic patients?

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 imp...

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Bibliographic Details
Published in:PloS one 2017-10, Vol.12 (10), p.e0183485-e0183485
Main Authors: Vena, Antonio, Muñoz, Patricia, Padilla, Belen, Valerio, Maricela, Sanchez, Maria Isabel, Puig-Asensio, Mireia, Fortun, Jesus, Fernandez-Ruiz, Mario, Merino, Paloma, Losa, Juan Emilio, Loza, Ana, Rivas, Rosa Ana, Bouza, Emilio
Format: Article
Language:English
Subjects:
Aged
Antibiotics
Antifungal agents
Antifungal Agents - therapeutic use
Biology and Life Sciences
Candidemia
Candidemia - diagnostic imaging
Candidemia - drug therapy
Candidiasis
Care and treatment
Catheters
Complications and side effects
Diagnosis
Female
Fungicides
Hospitals
Humans
Infections
Infectious diseases
Lesions
Male
Medicine
Medicine and Health Sciences
Microbiology
Middle Aged
Ophthalmology
Ophthalmoscopes
Ophthalmoscopy - utilization
Patients
Population
Prospective Studies
Research and Analysis Methods
Spain
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Summary: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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0183485