title: Outcomes of Primary Transconjunctival 23-Gauge Vitrectomy in the Diagnosis and Treatment of Presumed Endogenous Fungal Endophthalmitis.
abstract: OBJECTIVE
  To report the outcomes of primary transconjunctival 23-gauge (23-G) vitrectomy in the diagnosis and treatment of presumed endogenous fungal endophthalmitis (EFE).
  
  
  METHODS
  Retrospective analysis of patients with EFE who underwent diagnostic transconjunctival 23-G vitrectomy at a tertiary referral center.
  
  
  RESULTS
  Nineteen eyes of 15 patients with EFE were included in the study. Four patients had bilateral and 11 patients unilateral disease. Sixteen eyes of 15 patients underwent 23-G vitrectomy to confirm the diagnosis using vitreous culture, polymerase chain reaction, and histopathologic examinations. All affected eyes were treated with intravitreal amphotericin B 5 µg/0.1 mL. Fourteen patients received additional systemic antifungal therapy. Diagnostic 23-G vitrectomy confirmed the diagnosis of EFE in 75% of the eyes (12/16). Candida was found to be a causative agent in 62.5% and Aspergillus in 12.5% of the eyes. Retinal detachment was the most common complication (42% of eyes).
  
  
  CONCLUSIONS
  EFE can be easily confirmed using primary 23-G vitrectomy.
authors.affiliation: a Centre for Ophthalmology , University of Tuebingen , Tuebingen , Germany.
authors.forename: Antony
authors.initials: A
authors.lastname: William
authors.affiliation: a Centre for Ophthalmology , University of Tuebingen , Tuebingen , Germany.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Spitzer
authors.affiliation: a Centre for Ophthalmology , University of Tuebingen , Tuebingen , Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Deuter
authors.affiliation: b Department of Clinical Epidemiology and Applied Biometry , University of Tuebingen , Tuebingen , Germany.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Blumenstock
authors.affiliation: a Centre for Ophthalmology , University of Tuebingen , Tuebingen , Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Partsch
authors.affiliation: a Centre for Ophthalmology , University of Tuebingen , Tuebingen , Germany.
authors.forename: Bogomil
authors.initials: B
authors.lastname: Voykov
authors.affiliation: a Centre for Ophthalmology , University of Tuebingen , Tuebingen , Germany.
authors.forename: Focke
authors.initials: F
authors.lastname: Ziemssen
authors.affiliation: a Centre for Ophthalmology , University of Tuebingen , Tuebingen , Germany.
authors.forename: Karl Ulrich
authors.initials: KU
authors.lastname: Bartz-Schmidt
authors.affiliation: a Centre for Ophthalmology , University of Tuebingen , Tuebingen , Germany.
authors.forename: Deshka
authors.initials: D
authors.lastname: Doycheva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D003228:Conjunctiva; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005658:Fungi / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000382:microbiology*
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B
keywords: Amphotericin B; diagnosis; endogenous fungal endophthalmitis; transconjunctival 23-gauge vitrectomy; treatment