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% CI, 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.