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FACTORS DETERMINING VISUAL OUTCOME IN ENDOGENOUS CANDIDA ENDOPHTHALMITIS

Purpose: To determine factors affecting the visual outcome of eyes with endogenous Candida endophthalmitis. Methods: Retrospective cohort study of 44 eyes from 36 patients diagnosed with candida endophthalmitis at 2 tertiary referral uveitis centers. Outcome measures included the development of retinal detachment and the occurrence of visual loss (visual acuity of <20/40) and severe visual loss (visual acuity of ⩽20/200). Results: Twenty four of 44 eyes (55%) had visual loss and 16 of 44 eyes (32%) had severe visual loss by the end of the study. Early vitrectomy significantly reduced the risk of retinal detachment (P = 0.02). Factors associated with poor visual outcome included poor presenting visual acuity (relative risk = 2.38; 95% confidence interval, 1.01–5.55; P < 0.05) and centrally located fungal lesions (relative risk = 5.01; 95% confidence interval, 1.00–2.52; P < 0.05). Conclusion: Candida endophthalmitis is associated with a high rate of visual loss, particularly in patients with poor presenting visual acuity or centrally located lesions. Early vitrectomy reduces the risk of retinal detachment.