title: Intravitreal voriconazole for drug-resistant fungal endophthalmitis: case series.
abstract: OBJECTIVE
  To report the efficacy of intravitreal voriconazole.
  
  
  METHODS
  Retrospective analysis of an interventional case series of five cases of culture-proven fungal endophthalmitis treated with intravitreal voriconazole was done. Only cases found to be resistant to conventional antifungal agents were included in the study. The diagnosis of fungal endophthalmitis was established on the basis of clinical as well as microbiological examination. All patients received one or more intravitreal injections of voriconazole. Resolution was determined on the basis of clinical examination. Resolution of infection and final visual acuity were the main outcome measures.
  
  
  RESULTS
  Resolution of infection was achieved in all five cases. Visual acuity was better in three cases and was maintained in two. Of the three patients who had improvement, two had vision better than or equal to 20/120. Evisceration was avoided in one case with maximal antifungal treatment including voriconazole.
  
  
  CONCLUSIONS
  Voriconazole definitely adds to the available treatment options for fungal endophthalmitis. Because of its broad spectrum of activity, it is efficacious in even amphotericin-B- and fluconazole-resistant fungal endophthalmitis.
authors.affiliation: Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, India.
authors.forename: Parveen
authors.initials: P
authors.lastname: Sen
authors.forename: Lingam
authors.initials: L
authors.lastname: Gopal
authors.forename: Pratik Ranjan
authors.initials: PR
authors.lastname: Sen
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D025141:Drug Resistance, Fungal; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies; D014230:Triazoles / Q000627:therapeutic use*; D014792:Visual Acuity; D014822:Vitreous Body; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D015725:Fluconazole; D065819:Voriconazole