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Prevalence of ocular candidiasis and Candida endophthalmitis in patients with candidemia: A systematic review and meta-analysis

Kasidis Phongkhun, T. Pothikamjorn, Karan Srisurapanont, Kasama Manothummetha, A. Sanguankeo, Achitpol Thongkam, Nipat Chuleerarux, Surachai Leksuwankun et al.

Clinical Infectious Diseases, 2023

8,599 participants · 56 citations

Abstract

BACKGROUND

Infectious diseases and ophthalmology professional societies have disagreed regarding ocular screening in patients with candidemia. This study aimed to summarize the current evidence on the prevalence of ocular candidiasis (OC) and Candida endophthalmitis (CE) according to the standardized definitions.

METHODS

A literature search was conducted from the 1990s through October 16th, 2022, using PubMed, Embase, and SCOPUS. Pooled prevalence of ocular complications was derived from generalized linear mixed models. (PROSPERO CRD42022326610).

RESULTS

A total of 70 and 35 studies were included in the meta-analysis for OC and concordant CE (chorioretinitis with vitreous involvement), respectively. This study represented 8,599 patients with candidemia who underwent ophthalmologic examination. The pooled prevalence [95% confidence interval] of OC, overall CE, concordant CE, and discordant CE were 10.7% [8.4%-13.5%], 3.1% [2.1%-4.5%], 1.8% [1.3%-2.6%], and 7.4% [4.5%-12%] of patients screened, respectively. Studies from Asian countries had significantly higher concordant CE prevalence of patients screened [95% CI] of 3.6% [2.9% - 4.6%] compared to studies from European countries of 1.4% [0.4% - 5%] and American countries of 1.4% [0.9% - 2.2%], p-value <0.01. Presence of total parenteral nutrition and C. albicans were associated with CE with pooled odds ratios [95% CI] of 6.92 [3.58-13.36] and 3.02 [1.67-5.46], respectively.

CONCLUSION

Prevalence of concordant CE overall and…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 8,599 participants or records.

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