Fungal Endophthalmitis

  • Alessandro Invernizzi
Living reference work entry


Fungal endophthalmitis is defined as the intraocular presence of fungi, involving the vitreous and/or the aqueous humors, accompanied by an inflammatory reaction. The epidemiology of fungal endophthalmitis is highly influenced by the environment, the climate, and people living conditions. Endogenous invasion of the eye usually begins with the localization of microorganisms carried by the bloodstream at the level of the choroid or, the retina (fungal chorioretinitis). Exogenous fungal endophthalmitis is usually post-surgical/post traumatic, and can be characterized by a delayed onset and a less aggressive behavior as compared to bacterial.

The treatment of fungal endophthalmitis is based on a combination of systemic and intravitreal antimycotic drugs usually associated with pars plana vitrectomy.

The visual outcome is variable ad depends on a correct management of the disease, on the lesions location, the causative agent and the stage at presentation.


Optical Coherence Tomography Anterior Chamber Best Correct Visual Acuity Epiretinal Membrane Posterior Chamber 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Aguilar GL, Blumenkrantz MS, Egbert PR, McCulley JP. Candida endophthalmitis after intravenous drug abuse. Arch Ophthalmol. 1979;97(1):96–100.CrossRefPubMedGoogle Scholar
  2. Beebe WE, Kirkland C, Price J. A subretinal neovascular membrane as a complication of endogenous Candida endophthalmitis. Ann Ophthalmol. 1987;19(6):207–9.PubMedGoogle Scholar
  3. Brooks RG. Prospective study of Candida endophthalmitis in hospitalized patients with candidemia. Arch Intern Med. 1989;149(10):2226–8.CrossRefPubMedGoogle Scholar
  4. Callanan D, Scott IU, Murray TG, Oxford KW, Bowman CB, Flynn Jr HW. Early onset endophthalmitis caused by Aspergillus species following cataract surgery. Am J Ophthalmol. 2006;142:509–11.CrossRefPubMedGoogle Scholar
  5. Chakrabarti A, Shivaprakash MR, Singh R, Tarai B, George VK, Fomda BA, Gupta A. Fungal endophthalmitis: fourteen years’ experience from a center in India. Retina. 2008;28(10):1400–7.CrossRefPubMedGoogle Scholar
  6. Cho M, Khanifar AA, Chan RV. Spectral-domain optical coherence tomography of endogenous fungal endophthalmitis. Retin Cases Brief Rep. 2011;5(2):136–40. doi:10.1097/ICB.0b013e3181cc2146.CrossRefPubMedGoogle Scholar
  7. Essman TF, Flynn Jr HW, Smiddy WE, Brod RD, Murray TG, Davis JL, Rubsamen PE. Treatment outcomes in a 10-year study of endogenous fungal endophthalmitis. Ophthalmic Surg Lasers. 1997;28(3):185–94.PubMedGoogle Scholar
  8. Henderson DK, Edwards Jr JE, Ishida K, Guze LB. Experimental hematogenous Candida endophthalmitis: diagnostic approaches. Infect Immun. 1979;23(3):858–62.PubMedPubMedCentralGoogle Scholar
  9. Jaeger EE, Carroll NM, Choudhury S, Dunlop AA, Towler HM, Matheson MM, Adamson P, Okhravi N, Lightman S. Rapid detection and identification of Candida, Aspergillus, and Fusarium species in ocular samples using nested PCR. J Clin Microbiol. 2000;38(8):2902–8.PubMedPubMedCentralGoogle Scholar
  10. Rao NA, Hidayat AA. Endogenous mycotic endophthalmitis: variations in clinical and histopathologic changes in candidiasis compared with aspergillosis. Am J Ophthalmol. 2001;132(2):244–51.CrossRefPubMedGoogle Scholar
  11. Riddell J, Comer GM, Kauffman CA. Treatment of endogenous fungal endophthalmitis: focus on new antifungal agents. Clin Infect Dis. 2011;52(5):648–53. doi:10.1093/cid/ciq204. Epub 2011 Jan 16.CrossRefPubMedGoogle Scholar
  12. Shen X, Xu G. Vitrectomy for endogenous fungal endophthalmitis. Ocul Immunol Inflamm. 2009;17(3):148–52. doi:10.1080/09273940802689396.CrossRefPubMedGoogle Scholar
  13. Smiddy WE. Treatment outcomes of endogenous fungal endophthalmitis. Curr Opin Ophthalmol. 1998;9(3):66–70.CrossRefPubMedGoogle Scholar
  14. Stern WH, Tamura E, Jacobs RA, Pons VG, Stone RD, O’Day DM, Irvine AR. Epidemic postsurgical Candida parapsilosis endophthalmitis. Clinical findings and management of 15 consecutive cases. Ophthalmology. 1985;92(12):1701–9.CrossRefPubMedGoogle Scholar
  15. Vaziri K, Schwartz SG, Kishor K, Flynn Jr HW. Endophthalmitis: state of the art. Clin Ophthalmol. 2015;9:95–108. doi:10.2147/OPTH.S76406. eCollection 2015.PubMedPubMedCentralGoogle Scholar
  16. Weissgold DJ, D’Amico DJ. Rare causes of endophthalmitis. Int Ophthalmol Clin. 1996;36(3):163–77.CrossRefPubMedGoogle Scholar
  17. Wykoff CC, Flynn HW Jr, Miller D, Scott IU, Alfonso EC. Exogenous fungal endophthalmitis: microbiology and clinical outcomes. Ophthalmology. 2008;115(9):1501–7, 1507.e1–2. doi:10.1016/j.ophtha.2008.02.027.Google Scholar
  18. Zhang YQ, Wang WJ. Treatment outcomes after pars plana vitrectomy for endogenous endophthalmitis. Retina. 2005;25(6):746–50.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Uveitis and Ocular Infectious Diseases Service - Eye Clinic, Department of Biomedical and Clinical ScienceLuigi Sacco Hospital, University of MilanMilanItaly

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