title: Intravitreal voriconazole for the treatment of endogenous Aspergillus endophthalmitis.
abstract: OBJECTIVE
  To describe the first use of intravitreal voriconazole in a human eye for the treatment of Aspergillus endophthalmitis.
  
  
  METHODS
  Interventional case report.
  
  
  METHODS
  A 22-year-old woman receiving immunosuppressive agents 5 weeks after lung transplantation who presented with blurred vision and redness in the right eye.
  
  
  METHODS
  Intravitreal injection of voriconazole (100 microg/0.1 ml) with pars plana vitrectomy, given after isolation of A. terreus in the vitreous sample. Previous treatment modalities, including vitrectomy with repeated intravitreal amphotericin B and systemic voriconazole, failed to prevent deterioration.
  
  
  METHODS
  Visual acuity (VA) and ocular inflammation.
  
  
  RESULTS
  Significant improvement was observed in VA (to 6/15) and in ocular inflammatory reaction. The patient recovered with no evidence of systemic fungal infection.
  
  
  CONCLUSIONS
  Intravitreal voriconazole may be used as an adjunct to systemic treatment in patients with Aspergillus endophthalmitis. Further clinical studies are needed to determine how often this approach can safely treat this condition.
authors.affiliation: Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel. umkramer@netvision.net.il
authors.forename: Michal
authors.initials: M
authors.lastname: Kramer
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
authors.forename: Hannah
authors.initials: H
authors.lastname: Blau
authors.forename: Jihad
authors.initials: J
authors.lastname: Bishara
authors.forename: Ruth
authors.initials: R
authors.lastname: Axer-Siegel
authors.forename: Dov
authors.initials: D
authors.lastname: Weinberger
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy* / Q000382:microbiology; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007267:Injections; D016040:Lung Transplantation; D009894:Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology; D011743:Pyrimidines / Q000627:therapeutic use*; D014230:Triazoles / Q000627:therapeutic use*; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole