title: Topical and oral voriconazole in the treatment of fungal keratitis.
abstract: OBJECTIVE
  To describe nine patients with fungal keratitis refractory to standard antifungal therapy whose condition was managed with voriconazole.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Chart review of patients with fungal keratitis who were treated with topical and oral voriconazole.
  
  
  RESULTS
  Nine patients were treated. Two patients were contact lens wearers who used multipurpose cleaning solutions. Corneal isolates found were Fusarium (three patients), Candida albicans (three patients), Alternaria (one patient), Scopulariopsis (one patient), and Scedosporium apiospermum (one patient). Nine patients were treated with topical voriconazole, and eight patients were treated with oral voriconazole. Patients were treated topically for four to 16 weeks (mean, 10 weeks) and orally for five to 17 weeks (mean, 10 weeks). One patient was lost to follow-up. Two patients discontinued the topical voriconazole after one day and four weeks, respectively, because of ocular burning. Of the seven patients who were treated with topical therapy and followed, five conditions healed.
  
  
  CONCLUSIONS
  Voriconazole is a new, promising therapy for fungal keratitis that is refractory to standard antifungal treatments.
authors.affiliation: Cornea Service, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA 19107, USA.
authors.forename: Vatinee Y
authors.initials: VY
authors.lastname: Bunya
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Hammersmith
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Rapuano
authors.forename: Brandon D
authors.initials: BD
authors.lastname: Ayres
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Cohen
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; 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*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole