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Optical coherence tomography findings in fungal uveitis

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Abstract

Purpose

The purpose of the study was to describe the vitreal, retinal, and choroidal features of eyes affected by endogenous endophthalmitis (EE) and evaluate the effects of systemic antifungal drug treatment and pars plana vitrectomy by using spectral domain optical coherence tomography (SD-OCT).

Methods

Medical records and SD-OCT images of eyes diagnosed with EE at a single uveitis tertiary referral center in Brazil were acquired at the time of diagnosis, after 7 days of high-dose antifungal drug treatment, and at follow-up assessments performed 30 days after resolution.

Results

Thirteen eyes were enrolled in the study. All patients showed hyperreflective round-shaped lesions on SD-OCT and pre-retinal aggregates. Five eyes responded to antifungal systemic oral drugs despite showing vitreous opacity. The response to treatment was observable on optical coherence tomography (OCT) images.

Conclusion

Fungal endophthalmitis showed typical features on SD-OCT, facilitating early diagnosis and treatment despite the absence of vitreous culture or biopsy. This study suggests that OCT images can be used to support diagnosis by physicians who do not have access to vitreoretinal surgery.

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References

  1. Okada AA, Johnson RP, Liles WC, D’Amico DJ, Baker AS (1994) Endogenous bacterial endophthalmitis. Report of a ten-year retrospective study. Ophthalmology 101(5):832–838

    Article  CAS  PubMed  Google Scholar 

  2. Shrader SK, Band JD, Lauter CB, Murphy P (1990) The clinical spectrum of endophthalmitis: incidence, predisposing factors, and features influencing outcome. J Infect Dis 162(1):115–120

    Article  CAS  PubMed  Google Scholar 

  3. Ramakrishnan R, Bharathi MJ, Shivkumar C, Mittal S, Meenakshi R, Khadeer MA et al (2009) Microbiological profile of culture-proven cases of exogenous and endogenous endophthalmitis: a 10-year retrospective study. Eye (Lond) 23(4):945–956

    Article  CAS  PubMed  Google Scholar 

  4. Ness T, Pelz K, Hansen LL (2007) Endogenous endophthalmitis: microorganisms, disposition and prognosis. Acta Ophthalmol Scand 85(8):852–856

    Article  PubMed  Google Scholar 

  5. Sadiq MA, Hassan M, Agarwal A, Sarwar S, Toufeeq S, Soliman MK et al (2015) Endogenous endophthalmitis: diagnosis, management, and prognosis. J Ophthalmic Inflamm Infect 5(1):32

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sallam A, Lynn W, McCluskey P, Lightman S (2006) Endogenous Candida endophthalmitis. Expert Rev Anti Infect Ther 4(4):675–685

    Article  PubMed  Google Scholar 

  7. Felton T, Troke PF, Hope WW (2014) Tissue penetration of antifungal agents. Clin Microbiol Rev 27(1):68–88

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chopra R, Wagner SK, Keane PA (2021) Optical coherence tomography in the 2020s-outside the eye clinic. Eye (Lond) 35(1):236–243

    Article  PubMed  Google Scholar 

  9. Invernizzi A, Symes R, Miserocchi E, Cozzi M, Cereda M, Fogliato G et al (2018) Spectral domain optical coherence tomography findings in endogenous Candida endophthalmitis and their clinical relevance. Retina 38(5):1011–1018

    Article  PubMed  Google Scholar 

  10. Zhuang H, Ding X, Gao F, Zhang T, Ni Y, Chang Q et al (2020) Optical coherence tomography features of retinal lesions in Chinese patients with endogenous Candida endophthalmitis. BMC Ophthalmol 20(1):52

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lavine JA, Mititelu M (2015) Multimodal imaging of refractory Candida chorioretinitis progressing to endogenous endophthalmitis. J Ophthalmic Inflamm Infect 5(1):54

    Article  PubMed  Google Scholar 

  12. Adam MK, Rahimy E (2015) Enhanced depth imaging optical coherence tomography of endogenous fungal chorioretinitis. JAMA Ophthalmol 133(11):e151931

    Article  PubMed  Google Scholar 

  13. Adam CR, Sigler EJ (2014) Multimodal imaging findings in endogenous Aspergillus endophthalmitis. Retina 34(9):1914–1915

    Article  PubMed  Google Scholar 

  14. Gallagher MJ, Yilmaz T, Cervantes-Castañeda RA, Foster CS (2007) The characteristic features of optical coherence tomography in posterior uveitis. Br J Ophthalmol 91(12):1680–1685

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Rao NA, Hidayat AA (2001) Endogenous mycotic endophthalmitis: variations in clinical and histopathologic changes in candidiasis compared with aspergillosis. Am J Ophthalmol 132(2):244–251

    Article  CAS  PubMed  Google Scholar 

  16. Omuta J, Uchida K, Yamaguchi H, Shibuya K (2007) Histopathological study on experimental endophthalmitis induced by bloodstream infection with Candida albicans. Jpn J Infect Dis 60(1):33–39

    PubMed  Google Scholar 

  17. Cho M, Khanifar AA, Chan RVP (2011) Spectral-domain optical coherence tomography of endogenous fungal endophthalmitis. Retin Cases Brief Rep 5(2):136–140

    Article  PubMed  Google Scholar 

  18. Bennett J. Agentes antimicrobianos, agentes antifúngicos. Goodman & Gilman: as bases farmacológicas da terapêutica. 11a ed. Rio de Janeiro: McGraw-Hill; c2007. p. 1103–17

  19. Dotto Pde F, Rodrigues LD, Fernandes Mde L, Figueira BB, Takahashi WY, Carani JC et al (2005) Intravenous fluconazole use in the treatment of fungic endogenous endophthalmitis: case report. Arq Bras Oftalmol 68(4):543–546

    PubMed  Google Scholar 

  20. Christmas NJ, Smiddy WE (1996) Vitrectomy and systemic fluconazole for treatment of endogenous fungal endophthalmitis. Ophthalmic Surg Lasers 27(12):1012–1018

    Article  CAS  PubMed  Google Scholar 

  21. Wellington M, Gigliotti F (2001) Update on antifungal agents. Pediatr Infect Dis J 20(10):993–995

    Article  CAS  PubMed  Google Scholar 

  22. Kim HM, Han H, Hong HK, Park JH, Park KH, Kim H et al (2021) Permeability of the retina and RPE-choroid-sclera to three ophthalmic drugs and the associated factors. Pharmaceutics 13(5):655

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. William A, Spitzer MS, Deuter C, Blumenstock G, Partsch M, Voykov B et al (2017) Outcomes of primary transconjunctival 23-gauge vitrectomy in the diagnosis and treatment of presumed endogenous fungal endophthalmitis. Ocul Immunol Inflamm 25(2):239–245

    Article  PubMed  Google Scholar 

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Acknowledgements

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Funding

The author(s) received no financial support for the authorship and/or publication of this article.

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Authors and Affiliations

  1. Clinical Research Laboratory of National Institute of Infectious Diseases (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil

    Fernando Henrique Flores Teixeira, Nathalia Silva Santos, Alexandre de Carvalho Mendes Paiva, Erika Moreira Carvalho, Ana Luiza Biancardi & André Luiz Land Curi

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  1. Fernando Henrique Flores Teixeira
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  2. Nathalia Silva Santos
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  3. Alexandre de Carvalho Mendes Paiva
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  4. Erika Moreira Carvalho
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  5. Ana Luiza Biancardi
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  6. André Luiz Land Curi
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Contributions

Dear Editor, All authors have actively contributed to the acquisition of data, its analysis and interpretation and the process of drafting the manuscript. The group leadership and article review were performed by André Curi and Ana Luiza Biancardi.

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Correspondence to Fernando Henrique Flores Teixeira.

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Teixeira, F.H.F., Santos, N.S., de Carvalho Mendes Paiva, A. et al. Optical coherence tomography findings in fungal uveitis. Int Ophthalmol 43, 3023–3030 (2023). https://doi.org/10.1007/s10792-023-02696-0

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  • DOI: https://doi.org/10.1007/s10792-023-02696-0

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