Optical coherence tomography features of retinal lesions in Chinese patients with endogenous Candida endophthalmitis

Hong Zhuang,Xinyi Ding,Fengjuan Gao,Qing Chang,Yingqin Ni,Gezhi Xu,Ting Zhang

doi:10.1186/s12886-020-01337-9

Hong Zhuang, Xinyi Ding + Show 5 more

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https://doi.org/10.1186/s12886-020-01337-9

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Abstract

BackgroundTo evaluate the optical coherence tomography (OCT) features of retinal lesions in Chinese patients with endogenous Candida endophthalmitis (ECE).MethodsWe performed a retrospective review of patients diagnosed with ECE at one medical center. The medical records of the patients including predisposing risk factors, treatment and visual acuity were reviewed. And we focused on the analysis of OCT images of retinal lesions before and after treatment.ResultsA total of 16 Chinese patients (22 eyes) were included in this study. The most frequent predisposing risk factors were intravenous use of corticosteroids or antibiotics, lithotripsy for urinary calculi, and diabetes. After treatment, visual acuity was improved in 13 (59.1%) of the 22 eyes, and remained the same in the other 9 (40.9%) eyes. Pre-treatment OCT images obtained at presentation were available for 17 of the 22 eyes. Four types of the OCT manifestations of retinal lesions were identified: type 1 (subretinal macular lesions), type 2 (lesions are located in the inner retinal layer), type 3 (lesions involve the full-thickness retina and accompanied with macular edema), type 4 (sub-inner limiting membrane lesions). Pre-treatment OCT imaging of the 17 eyes revealed five as type 1, four as type 2, six as type 3, and two as type 4. After treatment, OCT images revealed epiretinal membrane and subretinal fibrosis as the most common post-treatment complications of ECE. Epiretinal membrane was detected in 2/4 type 2 lesions, in 4/6 type 3 lesions, and in 1/2 type 4 lesions, while subretinal fibrosis was mainly seen in type 1 lesions (4/5). Among the types, visual prognosis was best in eyes with type 2 lesions.ConclusionsIn this case series, the OCT manifestations of retinal lesions in ECE could be classified into four types. The post-treatment OCT manifestations were different in four types of lesions. We preliminarily found that the OCT morphology of retinal lesions was associated with the visual prognosis of ECE.

Highlights

To evaluate the optical coherence tomography (OCT) features of retinal lesions in Chinese patients with endogenous Candida endophthalmitis (ECE)
The most frequent predisposing risk factors were intravenous use of corticosteroids or antibiotics, lithotripsy of urinary calculi, and diabetes
All ECE diagnoses were confirmed by microbial cultures

Summary

Introduction

To evaluate the optical coherence tomography (OCT) features of retinal lesions in Chinese patients with endogenous Candida endophthalmitis (ECE). Endogenous endophthalmitis is a vision-threatening intraocular infection that accounts for approximately 2–10% of all cases of endophthalmitis [1,2,3], which is reportedly increasing in incidence in East Asian. Zhuang et al BMC Ophthalmology (2020) 20:52 aggravation of ECE results in vitreous inflammation and disseminated lesions. Several single case studies have reported the manifestations of ECE on optical coherence tomography (OCT) [17,18,19]. A recent study has analyzed the OCT features of ECE in nine patients from four medical centers in Italy and Australia [20]. The incidence of ECE was increased in East Asia, there was still few OCT analysis of ECE in East Asian population

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