Fungal infection in patients with serpiginous choroiditis or acute zonal occult outer retinopathy.

The etiologies of a number of retinopathies, including serpiginous choroiditis and acute zonal occult outer retinopathy (AZOOR), remain uncertain. Recently, we provided evidence that AZOOR is caused by Candida famata infection. The purpose of this article was to investigate the presence of fungal infection in five patients affected with serpiginous choroiditis and five patients with diagnosis of AZOOR. To assess the presence of fungal infection the presence of antibodies in human serum samples against C. famata, C. albicans, C. parapsilosis, C. glabrata and C. krusei was analyzed. In addition, quantitative PCR was carried out to detect fungal genomes in whole blood. Finally, the presence of fungal antigens in the serum samples of patients was investigated. Three AZOOR patients presented high antibody titers against Candida spp., while antibodies against Candida spp. were observed in serum samples from four patients with serpiginous choroiditis. Fungal genomes in peripheral blood were evidenced in serum samples from one AZOOR and four serpiginous choroiditis patients. Fungal antigens were also apparent in the serum of different patients. Our findings indicate that there was evidence of disseminated fungal infection in most patients examined.