Published date: Apr 29 2022

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: April–June 2022, Volume 17, Issue 2

Pages: 303–305

DOI: 10.18502/jovr.v17i2.10807

Pasha Anvari - anvari.p@iums.ac.ir - https://orcid.org/0000-0002-3765-4206

Reza Mirshahi

Ahad Sedaghat

Khalil Ghasemi Falavarjani

Candida spp. is the most common cause of endogenous fungal endophthalmitis. The diagnosis of this rare disease is based on clinical findings supported by positive blood culture. Recently, it has been shown that optical coherence tomography (OCT) characteristic findings are beneficial in making a correct diagnosis of fungal infection in cases with endogenous endophthalmitis. The current photo-essay aims to highlight the role of OCT in diagnosis of Candida endogenous endophthalmitis where OCT imaging of one of the retinal lesions disclosed a pre-retinal hyper reflective lesion with overlying punctate vitreous opacities. We propose “inverted snowing-cloud” sign for this OCT pattern considering the resemblance of the vitreous opacities to snowflakes.

1. Vaziri K, Pershing S, Albini TA, Moshfeghi DM, Moshfeghi AA. Risk factors predictive of endogenous endophthalmitis among hospitalized patients with hematogenous infections in the United States. Am J Ophthalmol 2015;159:498–504.

2. Ness T, Pelz K, Hansen LL. Endogenous endophthalmitis: microorganisms, disposition and prognosis. Acta Ophthalmol Scand 2007;85:852–856.

3. Sallam A, Lynn W, McCluskey P, Lightman S. Endogenous Candida endophthalmitis. Expert Rev Anti Infect Ther 2006;4:675–685.

4. Invernizzi A, Symes R, Miserocchi E, Cozzi M, Cereda M, Fogliato G, et al. Spectral domain optical coherence tomography findings in endogenous Candida endophthalmitis and their clinical relevance. Retina 2018;38:1011–1018.

5. Zhuang H, Ding X, Gao F, Zhang T, Ni Y, Chang Q, et al. Optical coherence tomography features of retinal lesions in Chinese patients with endogenous Candida endophthalmitis. BMC Ophthalmol 2020;20:52.