Use of Optical Coherence Tomography and Optical Coherence Tomography Angiography in the Diagnosis and Follow-Up of Endogenous Candida Endophthalmitis: A Case Report.
Agnieszka Kubicka-TrząskaDawid BugaraKatarzyna Żuber-ŁaskawiecWeronika Pociej-MarciakAnna MarkiewiczBożena Romanowska-DixonIzabella Karska-BastaPublished in: Medicina (Kaunas, Lithuania) (2024)
Background: Endogenous Candida endophthalmitis (ECE) is a rare but sight-threatening disease. Patients with ECE present with various clinical signs and symptoms, which can complicate the diagnosis. The aim of this report was to demonstrate the outcomes of treatment and to diagnose macular complications caused by intraocular inflammation. Case presentation: A 41-year-old woman with a history of acute intermittent porphyria presented with a progressive vision loss in her left eye. Left-eye OCT revealed findings consistent with a fungal etiology, which was confirmed by the culture of swabs collected from a central vein catheter. The outcomes of intravenous fluconazole treatment were not satisfactory, and the patient developed recurrent attacks of porphyria, suggesting a porphyrogenic effect of systemic antifungal therapy. Repeated intravitreal injections with amphotericin B led to a gradual regression of inflammatory lesions. However, follow-up examinations revealed active macular neovascularization (MNV) on both OCT and OCTA scans. The patient was administered intravitreal bevacizumab. At the 11th month of follow-up, OCT and OCTA scans showed significant inflammatory lesions regression with macula scarring, and no MNV activity was detected. Conclusions: This case highlights the importance of OCT and OCTA as valuable noninvasive imaging techniques for the identification of ECE, the monitoring of its clinical course, and the diagnosis of macular complications.
Keyphrases
- optical coherence tomography
- diabetic retinopathy
- candida albicans
- cataract surgery
- oxidative stress
- case report
- optic nerve
- computed tomography
- vascular endothelial growth factor
- multiple sclerosis
- age related macular degeneration
- intensive care unit
- high dose
- high resolution
- risk factors
- single cell
- magnetic resonance
- mesenchymal stem cells
- biofilm formation
- metabolic syndrome
- high intensity
- cystic fibrosis
- type diabetes
- bone marrow
- pseudomonas aeruginosa
- escherichia coli
- combination therapy
- drug induced
- mass spectrometry
- adipose tissue
- low dose
- dual energy
- replacement therapy
- aortic dissection