Purpose: The purpose of this study is to report the use of spectral-domain optical coherence tomography in monitoring endogenous Candida endophthalmitis.
Methods: A patient diagnosed with candidemia was followed for endogenous Candida endophthalmitis. With each clinic visit, the patient underwent visual acuity assessment, slit-lamp biomicroscopy, dilated fundus examination, color fundus photography, spectral-domain optical coherence tomography, and fluorescein angiography.
Results: At initial examination, the patient's visual acuity was 20/200 in both eyes. Creamy yellow fungal lesions were visualized within one disk diameter of the fovea and along the arcades. These lesions, in various stages of evolution, were imaged with spectral-domain optical coherence tomography, localizing their depth within the retina. Deeper retinal lesions corresponded to early active inflammatory lesions as confirmed by hypofluorescent areas with late staining on the fluorescein angiography. More superficial lesions on the vitreoretinal interface corresponded to late inactive lesions corresponding to blocked areas on the fluorescein angiography. After the resolution of most lesions, her final visual acuity was 20/25 in both eyes at last follow-up.
Conclusion: The depth of lesions as shown by the spectral-domain optical coherence tomography corresponds to various stages of fungal infection, allowing clinicians to monitor the disease and its response to therapy.