Late-Onset Rhegmatogenous-Traction Retinal Detachment due to Candida Chorioretinitis

Susan Lightman, MD, PhD; Hamish Towler, MD; Robert Cooling, MD
Arch Ophthalmol. 1993;111(6):731. doi:10.1001/archopht.1993.01090060017005.
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To the Editor.  —Pesin et al1 described a patient with a combined rhegmatogenous-traction detachment developing after "... successful treatment of Candida chorioretinitis." We dispute their conclusion that the treatment was effective in view of the clinical course of events, and the amphotericin B, with its known poor ocular penetration,2 was used without any other concurrent intracameral antifungal therapy. Ocular inflammation was observed to resolve, but it is not clear whether this refers only to the anterior and not the posterior segment. The visual acuity remained poor for which no explanation was given, although after surgery the visual acuity improved to 20/60, suggesting that reversible disease was present at the time (eg, vitritis, disc swelling, macular edema, or fungal infiltration at the posterior pole).Pathologic examination of the fibrovascular tissue removed at surgery revealed fungal organisms consistent with Candida, providing clear evidence that fungus was still present inside the eye.


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