title: Intravitreal liposomal amphotericin B for treatment of endogenous candida endophthalmitis.
abstract: OBJECTIVE
  To evaluate the outcomes of intravitreal liposomal amphotericin B (L-AmB) for treatment of endogenous candida endophthalmitis.
  
  
  METHODS
  Medical records of four patients with endogenous candida endophthalmitis treated with intravitreal L-AmB injection alone or combined with vitrectomy were reviewed.
  
  
  RESULTS
  Endogenous candida endophthalmitis developed in two patients after gastrointestinal surgery, in one patient with sepsis, and in one patient undergoing systemic chemotherapy for metastatic breast cancer. Three eyes of two patients exhibited toxic uveitis following repetitive intravitreal injection of amphotericin B deoxycholate (AmB-D, 10 μg/0.1 ml). The other patients had general health issues that restricted the use of AmB-D due to the potential risk of systemic toxicity. Seven eyes underwent intravitreal injection of L-AmB (10 μg/0.1 ml) with or without vitrectomy. In these patients, intraocular inflammation and vitreous opacities resolved, and chorioretinal infiltrates evolved into fibrotic scars. Visual acuity improved and stabilized in all eyes during the follow-up period.
  
  
  CONCLUSIONS
  Intravitreal L-AmB seems to be well tolerated and effective in the treatment of endogenous candida endophthalmitis, and may be a reasonable alternative for patients who cannot endure the side effects or toxicity associated with conventional AmB-D therapy.
authors.affiliation: Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.|Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Jeong Hun
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Republic of Korea. sunglee@yuhs.ac.
authors.forename: Sung Chul
authors.initials: SC
authors.lastname: Lee
mesh_terms: D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D003131:Combined Modality Therapy; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014822:Vitreous Body / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B
keywords: AmBisome; Candida endophthalmitis; Intravitreal injection; Liposomal amphotericin B; Vitrectomy