Intravitreal voriconazole for drug-resistant fungal endophthalmitis: case series.
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.
Sen
Parveen
P
Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, India.
Gopal
Lingam
L
Sen
Pratik Ranjan
PR
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
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D015725:Fluconazole; D065819:Voriconazole