To the Editor.
—The article entitled "Intravitreal Amphotericin B Treatment of Candida Endophthalmitis" by Stern et al in the January Archives (95:89-93, 1977) suggests that intravitreal administration of amphotericin B might be preferred over intravenous administration of the drug in the treatment of selected cases of Candida endophthalmitis. Although intraocular lesions may develop after candidemia in the absence of other organ involvement, it is much more common for Candida endophthalmitis to be an indicator of widespread deep candidiasis.1 This ocular indicator is more reliable than any other clinical sign currently used to differentiate transient candidemia from deep organ candidiasis. Therefore, patients in whom intraocular candidiasis develops following candidemia should be treated preferentially with antifungal agents administered for systemic effect, not only to bring about resolution of the endophthalmitis itself, but to treat probable mycotic microabscesses in other vital organs, most commonly heart and kidneys.
Griffin JR. Ocular Indicator for Candida Endophthalmitis. Arch Ophthalmol. 1978;96(6):1095. doi:10.1001/archopht.1978.03910050605026