Endogenous mycotic endophthalmitis: variations in clinical and histopathologic changes in candidiasis compared with aspergillosis☆
Section snippets
Materials and methods
In this retrospective study, files of 25 patients with a diagnosis of endogenous Candida or Aspergillus endophthalmitis were reviewed. Files were obtained from the Armed Forces Institute of Pathology and the Ophthalmic Pathology Laboratory of the Doheny Eye Institute. Only cases with the globes removed at surgery or autopsy were included. The globes were examined macroscopically and sectioned primarily through the pathologic changes. The section included cornea, anterior chamber, the chamber
Results
Demographic features and underlying systemic diseases of the 25 cases are summarized in TABLE 1, TABLE 2. Patients initially presented with diagnoses of granulomatous anterior uveitis, vitritis, vitreoretinitis, panuveitis, chorioretinitis, or endophthalmitis (Table 3). Only one case of Aspergillus endophthalmitis presented with clinical features of a granulomatous anterior uveitis. Vitritis or vitreoretinitis was diagnosed in seven patients with Candida infection and two patients with
Discussion
The present clinicopathologic study of endogenous mycotic endophthalmitis reveals differences in the clinical presentations and histopathologic features of Candida endophthalmitis and aspergillosis. These include systemic predisposing conditions, extent of subretinal and choroidal involvement by the fungi, invasion of retinal and choroidal vessels by the organisms, and mortality from central nervous system involvement. As in previous reports, a history of gastrointestinal surgery and
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This work was supported in part by Grant EY03040, National Institutes of Health, Bethesda, Maryland, and Research to Prevent Blindness, New York, New York.