FUNGAL RETINITIS AND ENDOPHTHALMITIS

Abstract

Fungi constitute a prominent and diverse group of microorganisms. Despite their ubiquitous nature, only a limited number of fungal species produce infections of the eye, and an even smaller number cause fungal retinitis or endophthalmitis. These organisms are responsible for significant ocular morbidity, neverthe- less, and the prevalence of endogenous fungal retinitis and endophthalmitis is increasing because of the growing number of iatrogenically induced infections.87 It is practically impossible to discuss fungal retinitis separately from fungal endophthalmitis. Fungal retinitis, in most cases, is an endogenous infection that reaches the eye by way of the bloodstream. On reaching the eye, fungi usually lodge in the choroid or retina, producing choroiditis, retinitis, or chorioretinitis. When this initial focus of infection extends into the vitreous to produce inflammation, which may involve the entire internal structure of the eye, endophthalmitis results. The major causes of fungal retinitis are Candida species, Aspergillus species, Blastomyces dermatitidis, Coccidioides immitis, Cryptococcus neoformans, Histoplasma capsulatum, Pseudallescheria boydii, and Sporothrix schenckii. Although most of these organisms may produce endophthalmitis, they may also present as a focal chorioretinitis or a granuloma in the eye.87