Intravitreal voriconazole for the treatment of endogenous Aspergillus endophthalmitis.
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.
Kramer
Michal
M
Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel. umkramer@netvision.net.il
Kramer
Mordechai R
MR
Blau
Hannah
H
Bishara
Jihad
J
Axer-Siegel
Ruth
R
Weinberger
Dov
D
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
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole