Endogenous fungal endophthalmitis: causative organisms, management strategies, and visual acuity outcomes

Abstract

Purpose: To report the causative organisms, management strategies, and visual outcomes in endogenous fungal endophthalmitis.

Design: Observational case series.

Methods: Microbiologic and medical records were reviewed retrospectively for all patients with culture-positive endogenous fungal endophthalmitis between January 1, 1990, and July 1, 2009.

Results: Study criteria were met in 65 eyes of 51 patients with mean follow-up of 18 months. Yeasts were the most common causative organism in 38 (75%) patients compared with molds in 13 (25%) patients. Retinal detachment occurred in 17 eyes (26%). Visual acuity of 20/200 or better was present in 28 (56%) eyes with yeasts and in 5 (33%) eyes with molds at the last follow-up.

Conclusions: Yeasts were the most common cause of culture-proven unilateral or bilateral endogenous fungal endophthalmitis. Endogenous fungal endophthalmitis generally is associated with poor visual acuity outcomes, especially when caused by molds. Retinal detachment is a frequent occurrence during follow-up.