CHOROIDAL NEOVASCULARIZATION SECONDARY TA CANDIDA-ALBICANS CHORIORETINITIS

PURPOSE: To study the clinical histories and courses of six patients w ith choroidal neovascularization secondary to endogenous Candida albic ans chorioretinitis, METHODS: The medical records, fundus photographs, and fluorescein angiograms of six patients who developed C. albicans chorioretinitis secondary to candidemia and who subsequently developed choroidal neovascularization in one or both eyes were reviewed. RESUL TS: The six patients ranged in age from 18 to 79 years, Four were wome n and two men; all but one showed evidence of bilateral chorioretinal scarring secondary to C. albicans chorioretinitis. All patients had be en treated successfully with systemic antifungal therapy (amphotericin B). Two weeks to two years after the chorioretinitis, choroidal neova scularization developed in one eye (four cases) or both eyes (two case s), The neovascularization on initial examination was subfoveal in fou r eyes, extrafoveal in three eyes, and juxtafoveal in one eye, Laser p hotocoagulation was used in four of the eight involved eyes. In these cases, the active choroidal neovascularization was brought under contr ol, In one eye, the patient had submacular surgery for excision of the choroidal neovascular membrane, Final visual acuities ranged from 20/ 20 to 20/200 in treated eyes and from 20/50 to 20/400 in untreated eye s. CONCLUSION: Choroidal neovascularization is a potential cause of la te visual loss in patients who have had C. albicans sepsis and endogen ous C. albicans chorioretinitis. Eyes that have chorioretinal scarring from C. albicans chorioretinitis should be watched for the developmen t of choroidal neo vascularization. Laser photocoagulation or perhaps surgical excision of the neovascular complex may be of benefit in sele cted cases.