Journal in a minute
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Clinical question
Candida in blood.
Look in the eye?
A new multicentre cohort examines the yield – and the uncertainty.
The cohort
402
adults with candidemia
2tertiary hospitals
7years reviewed
Fundoscopy result
15 of 307
had probable ocular candidiasis
That is 4.9%. Twelve had probable chorioretinitis; three probable endophthalmitis.
The surprise
60%
were silent or unable to report symptoms
15
9
Clinical impact
Management changed in all 15
Patient outcome
3
had persistent visual impairment
All three were symptomatic at baseline.
Bottom line
Symptoms alone miss disease.
But a retrospective cohort cannot prove that routine fundoscopy improves patient outcomes.
Useful evidence – not the final answer.
Should every patient with Candida in the bloodstream have an eye examination?
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