To evaluate the factors associated with the development of ocular candidiasis (OC) and ocular prognosis with echinocandin therapy for candidemia. The medical records of 56 consecutive patients with a positive blood culture for Candida species between November 2016 and October 2019 were retrospectively reviewed. Information on patient characteristics, isolated Candida species, treatment details for candidemia, and ocular findings were extracted to identify factors associated with OC development. The leading pathogen of candidemia was Candida albicans (C.albicans) (41.1%). Of 56 patients, 18 (32.1%) were diagnosed with chorioretinitis, categorized as either probable (8 patients) or possible OC (10 patients). There was no case of endophthalmitis with vitritis. The incidence of probable OC was not significantly different between the groups treated with echinocandins and other antifungal drugs (15.2% vs. 11.1%, p = 1.00). In all probable OC cases, systemic antifungal therapy was switched from echinocandins to azoles, and no case progressed to endophthalmitis. A multivariate logistic analysis revealed that female sex (adjusted odds ratio [aOR], 8.93; 95% confidence interval [CI], 1.09–72.9) and C. albicans (aOR, 23.6; 95% CI, 1.8–281) were independent factors associated with the development of probable OC. One-seventh of patients with candidemia developed probable OC. Given the evidence of female and C. albicans as the factors associated with OC development, careful ophthalmologic management is required with these factors, especially in candidemia. Although echinocandins had no correlation with OC development and did not lead to the deterioration of ocular prognosis, further investigation is required.

中文翻译：

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棘白菌素治疗念珠菌病与眼部念珠菌病发展和眼部预后相关的因素

评估与眼念珠菌病 (OC) 发展相关的因素以及棘白菌素治疗念珠菌血症的眼部预后。回顾性回顾了2016年11月至2019年10月期间56名念珠菌属血培养阳性患者的病历。提取有关患者特征、分离的念珠菌属物种、念珠菌血症的治疗细节和眼部检查结果的信息，以确定与 OC 发展相关的因素。念珠菌血症的主要病原体是白色念珠菌（C.albicans）（41.1%）。在 56 名患者中，18 名 (32.1%) 被诊断为脉络膜视网膜炎，分为可能的（8 名患者）或可能的 OC（10 名患者）。无玻璃体炎伴眼内炎病例。棘白菌素类药物和其他抗真菌药物治疗组之间可能的 OC 发生率没有显着差异（15.2% 对 11.1%，p = 1.00）。在所有可能的 OC 病例中，全身抗真菌治疗从棘白菌素改为唑类，没有病例进展为眼内炎。多变量逻辑分析显示女性（调整后的比值比 [aOR]，8.93；95% 置信区间 [CI]，1.09-72.9）和白色念珠菌（aOR，23.6；95% CI，1.8-281）是独立因素与可能的 OC 的发展有关。七分之一的念珠菌血症患者发展为可能的 OC。鉴于女性和白色念珠菌是与 OC 发展相关的因素的证据，需要对这些因素进行仔细的眼科管理，尤其是念珠菌血症。