Association of candidemia and retinopathy of prematurity in very low birthweight infants

Objective: To determine if the presence of candidemia in infants is associated with an increased incidence of threshold retinopathy of prematurity (ROP). Design: Retrospective, case-controlled study. Participants and Controls: Forty-six infants admitted to the Texas Children's Hospital Neonatal Intensive Care Unit between 1989 and 1999 with a birth weight 1500 g or less, estimated gestational age (EGA) 28 weeks or less, and in whom candidemia developed were matched to a control group of 46 infants based on corresponding birth weight, EGA, and year of birth. Methods: Records of each infant were reviewed to determine the presence and severity of ROP. Main Outcome Measures: Development of threshold ROP, including retinal detachment. Results: Forty-three infants (93.5%) with candidemia and 39 (84.8%) without candidemia had ROP. Twenty-four infants (52.2%) with candidemia reached threshold and required surgical intervention, compared with 11 infants (23.9%) without candidemia (adjusted odds ratio [OR], 7.4; 95% confidence interval [CI], 1.7-32.1; P = 0.008). Retinal detachment developed in 10 of 24 candidemic infants (41.7%) who reached threshold ROP, compared with 2 of 11 infants (18.2%) without candidemia (OR, 4.4; 95% Cl, 0.73-26.9; P = 0.1). Conclusions: Candidemia is associated with increased risk of threshold ROP. Infants with Candida sepsis should be monitored closely for the development of ROP and progression after treatment. (C) 2002 by the American Academy of Ophthalmology.