Voriconazole in the treatment of fungal eye infections: a review of current literature.
BACKGROUND
Voriconazole has an important role to play in the prophylaxis and management of fungal endophthalmitis and keratitis. New-generation triazoles, including voriconazole, posaconazole and ravuconazole, have been shown in laboratory studies and clinical experience to have very good safety profiles with few side effects. Fungal eye infections, while not common in temperate climates, have been notoriously difficult to diagnose and treat, and generally result in protracted therapy with poor final outcomes. Current treatment options are far from optimal.


OBJECTIVE
This paper will review studies and clinical case reports published in the ophthalmic literature that address the safety of these drugs in the eye, penetration and concentration in ocular tissues and media, and efficacy in treating common pathogens implicated in fungal keratitis and endophthalmitis.


CONCLUSIONS
Over 40 clinical case reports of treatment with voriconazole suggest that it may be used safely and effectively against a broad range of fungal pathogens.
Hariprasad
S M
SM
Department of Ophthalmology and Visual Science, Vitreoretinal Service, University of Chicago, 5841 South Maryland Avenue-MC 2114, Chicago, IL 60637, USA. retina@uchicago.edu
Mieler
W F
WF
Lin
T K
TK
Sponsel
W E
WE
Graybill
J R
JR
D000818:Animals; D000935:Antifungal Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D011743:Pyrimidines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome; D014230:Triazoles / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole