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Xie Y, Wang X, Ji Z, Li G, Zhang C. The Effectiveness and Safety of Intravitreal Injections of Voriconazole in the Treatment of Fungal Endophthalmitis: A Systematic Review. J Ocul Pharmacol Ther 2023. [PMID: 38011696 DOI: 10.1089/jop.2023.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Background: Fungus endophthalmitis is a rare and serious infection that is treated with systemic and topical antifungal drugs. There is no clear consensus on the treatment of fungal endophthalmitis with intravitreal injections (IVIs) of voriconazole. This systematic review aims to summarize the literature on IVIs of voriconazole for fungal endophthalmitis. Methods: We conducted a systematic review of the literature to determine the effectiveness and safety of IVIs of voriconazole in the treatment of fungal endophthalmitis. We searched databases such as PubMed and Embase using the following search terms "Endophthalmitis" AND "Intravitreal Injections" AND "Voriconazole" with date limits of January 1, 1900, to December 31, 2022. We included all reports on humans, which described clinical outcomes of IVIs of voriconazole in the treatment of fungal endophthalmitis, including randomized controlled trials (RCTs) and case series. A descriptive synthesis of the data was conducted with a pooling of data for interventions. Results: One RCT and 21 retrospective studies were analyzed in this review. In these reports, a wide range of heterogeneous treatment regimens was used, including IVI in combination with other drugs, systemic therapy in combination with other agents, and surgery. Combined with other treatments, intravitreal voriconazole results in a favorable anatomical and clinical cure that was well tolerated. Conclusions: Reports on IVIs of voriconazole for fungal endophthalmitis demonstrate a heterogeneous approach to treatment. Of these, IVIs of voriconazole in anatomical and clinical outcomes appeared to be highly effective, although more data on its safety are needed.
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Affiliation(s)
- Yue Xie
- Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xin Wang
- Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zichao Ji
- Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Guangyao Li
- Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Chao Zhang
- Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Shahin AV, Elkhayat AI, Greene JN. Endogenous Vancomycin-Resistant Enterococcus gallinarum Endophthalmitis in Hematologic Malignancy. Infect Dis Clin Pract 2020; 28:301-304. [DOI: 10.1097/ipc.0000000000000856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yang C, Gao L, Liu X, Yang T, Yin G, Chen J, Guo H, Yu B, Cong H. Injectable Schiff base polysaccharide hydrogels for intraocular drug loading and release. J Biomed Mater Res A 2019; 107:1909-1916. [DOI: 10.1002/jbm.a.36677] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/10/2019] [Accepted: 03/15/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Chao Yang
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
- Institute of Complexity Science, Automation CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Lilong Gao
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Xiyan Liu
- Marine Chemical Research Institute Qingdao Shandong, 266071 People's Republic of China
| | - Ting Yang
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Guangming Yin
- Material Science and Engineering CollegeBeijing University of Chemical Technology Beijing, 100029 People's Republic of China
| | - Jianyu Chen
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Haiyong Guo
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Bing Yu
- Chemistry and Chemical Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
| | - Hailin Cong
- Material Science and Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
- Chemistry and Chemical Engineering CollegeQingdao University Qingdao Shandong, 266071 People's Republic of China
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Seidel D, Meißner A, Lackner M, Piepenbrock E, Salmanton-García J, Stecher M, Mellinghoff S, Hamprecht A, Durán Graeff L, Köhler P, Cheng MP, Denis J, Chedotal I, Chander J, Pakstis DL, Los-Arcos I, Slavin M, Montagna MT, Caggiano G, Mares M, Trauth J, Aurbach U, Vehreschild MJGT, Vehreschild JJ, Duarte RF, Herbrecht R, Wisplinghoff H, Cornely OA. Prognostic factors in 264 adults with invasive Scedosporium spp. and Lomentospora prolificans infection reported in the literature and FungiScope®. Crit Rev Microbiol 2019; 45:1-21. [DOI: 10.1080/1040841x.2018.1514366] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Danila Seidel
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Arne Meißner
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Department of Hospital Hygiene and Infection Control, University Hospital Cologne, Cologne, Germany
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Ellen Piepenbrock
- Department of Immunology and Hygiene, Institute for Medical Microbiology, University of Cologne, Cologne, Germany
| | - Jon Salmanton-García
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
| | - Sibylle Mellinghoff
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Axel Hamprecht
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Luisa Durán Graeff
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - Philipp Köhler
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
| | - Matthew P. Cheng
- Division of Infectious Diseases and Department of Medical Microbiology, McGill University Health Centre, Montreal, Canada
| | - Julie Denis
- Hôpitaux Universitaires, Department of Parasitology and Mycology, Plateau Technique de Microbiologie, FMTS, Université de Strasbourg, Strasbourg, France
| | - Isabelle Chedotal
- Oncology and Hematology Department, University Hospital of Strasbourg and INSERM U1113, Strasbourg, France
| | - Jagdish Chander
- Department of Microbiology, Government Medical College Hospital, Chandigarh, India
| | | | - Ibai Los-Arcos
- Infectious Diseases Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Monica Slavin
- University of Melbourne, Melbourne, Australia, The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Maria Teresa Montagna
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppina Caggiano
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Mihai Mares
- Laboratory of Antimicrobial Chemotherapy, Ion Ionescu de la Brad University, Iași, Romania
| | - Janina Trauth
- Medical Clinic II – Infectious Diseases, University Hospital Giessen/Marburg, Giessen, Germany
| | - Ute Aurbach
- Laboratory Dr. Wisplinghoff, Cologne, Germany
| | - Maria J. G. T. Vehreschild
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jörg Janne Vehreschild
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany
| | - Rafael F. Duarte
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Raoul Herbrecht
- Oncology and Hematology Department, University Hospital of Strasbourg and INSERM U1113, Strasbourg, France
| | - Hilmar Wisplinghoff
- Department of Immunology and Hygiene, Institute for Medical Microbiology, University of Cologne, Cologne, Germany
- Laboratory Dr. Wisplinghoff, Cologne, Germany
- Institute for Virology and Clinical Microbiology, Witten/Herdecke University, Witten, Germany
| | - Oliver A. Cornely
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Partner site Bonn - Cologne, German Centre for Infection Research (DZIF), Cologne, Germany
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany
- Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
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Affiliation(s)
- Diem K. Bui
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
| | - Petros E. Carvounis
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
- The George Washington University, Washington, District of Columbia
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Fernandez-Flores A, Lopez-Medrano R, Fuster-Foz C. Histopathological clues in the diagnosis of fungal infection byScedosporiumin a case of endophthalmitis starting as conjunctivitis. J Cutan Pathol 2016; 43:461-7. [DOI: 10.1111/cup.12689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 07/04/2015] [Accepted: 09/06/2015] [Indexed: 12/26/2022]
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Vanzzini-Zago V, Corredor-Casas S, Rodríguez-Reyes A, Hernández-Hernández F, Manzano-Gayosso P, Martínez RL, Orozco ARA. Endophthalmitis of probable endogenous origin caused by Scedosporium boydii: A case report. Rev Iberoam Micol 2016; 33:122-5. [PMID: 26874584 DOI: 10.1016/j.riam.2015.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 07/22/2015] [Accepted: 07/24/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Mycotic ocular infections caused by the Scedosporium apiospermum species complex are challenging to treat because of the delayed diagnoses and poor responses to antifungal drugs and surgical treatment. CASE REPORT A case of a 69-year-old male patient with a history of diabetes mellitus type 2 and prior surgery on the right femur is described. In the 10 days prior to the ophthalmic consultation he started with ocular pain, adding to a previous and progressive loss of visual acuity in his right eye. The diagnosis of endophthalmitis of probable endogenous origin was established. Despite medical treatment, the patient's condition worsened and, due to the imminent risks, an enucleation was performed. Smears of the enucleation tissue revealed fungal cells, and the cultures yielded a fungus belonging to the S. apiospermum species complex, which was identified as Scedosporium boydii by morphological characteristics and sequencing of a PCR amplicon. CONCLUSIONS A diagnosis of endophthalmitis of probable endogenous origin in the right eye was based on a previous right femur surgery. Potential risk to the patient led to enucleation.
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Affiliation(s)
- Virginia Vanzzini-Zago
- Laboratorio de Microbiología del Hospital Asociación para evitar la Ceguera en México, Mexico.
| | - Sonia Corredor-Casas
- Ophthalmic Pathology Chief, Instituto Mexicano de Oftalmología IAP Querétaro - Querétaro, Mexico
| | | | - Francisca Hernández-Hernández
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F., Mexico
| | - Patricia Manzano-Gayosso
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F., Mexico
| | - Rubén López Martínez
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F., Mexico
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Moloney TP, Park J. PSEUDALLESCHERIA ENDOPHTHALMITIS: FOUR CASES OVER 15 YEARS IN QUEENSLAND, AUSTRALIA, AND A REVIEW OF THE LITERATURE. Retina 2014; 34:1683-701. [DOI: 10.1097/iae.0000000000000126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
PURPOSE To describe the imaging appearance of Scedosporium apiospermum (S. apiosermum) endophthalmitis in an immunocompetent female who underwent high resolution magnetic resonance imaging (MRI) of the orbits and showed subchoroidal abscess on diffusion-weighted imaging. METHODS WE HIGHLIGHT UTILITY OF MRI SEQUENCES: diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), fluid-attenuated inversion recovery (FLAIR), and contrast-enhanced magnetic resonance imaging (CE-MRI) in the detection of a subchoroidal abscess and characterization of the inflammatory change of the uveal tract. Vitreous culture grew S. apiospermum. CONCLUSION Fungal endophthalmitis is a rare but aggressive process. Clinically, it can mimic other disease entities such as neoplasm. To the best of our knowledge, this is the first case that describes the CT and MRI imaging findings of S. apiospermum endophthalmitis. We emphasize the use of DWI and ADC sequences in the detection of subchoroidal abscess.
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Affiliation(s)
- Sandeep Bhuta
- Griffith University, School of Medicine, Department of Medical Imaging, Gold Coast Hospital, Southport, Gold Coast, QLD, Australia
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Abstract
PURPOSE To investigate the therapeutic efficacy and optimal drug dose of an intravitreally implantable voriconazole (VCZ) drug delivery system (DDS) in experimental endophthalmitis of Aspergillus fumigatus. METHODS Vitrectomy was performed in albino rabbits with intravitreal inoculation of susceptible A. fumigatus. The animals were randomized into groups of control, polylactic-co-glycolic acid implantation, VCZ injection, and intravitreal VCZ DDS containing 0.5, 0.9, and 1.2 mg of VCZ, respectively. The therapeutic effect was assessed by clinical observation, histology, and microbiology. RESULTS The inflammation in the VCZ injection and DDS groups was milder than the untreated and polylactic-co-glycolic acid groups (P ≤ 0.046). The 0.9-mg and 1.2-mg DDS groups presented milder anterior chamber and vitreous inflammation than the injection group during the first 3 weeks (P ≤ 0.044), but only the 1.2-mg DDS group had clearer vitreous thereafter (P ≤ 0.037). Smear and fungal culture showed negative results in all DDS groups. Normal histologic structure of the retina was observed in the eyes recovering from endophthalmitis. CONCLUSION The therapeutic effect of intravitreal VCZ DDS on fungal endophthalmitis appears to be significantly better than intravitreal injection of VCZ. The optimal dose of VCZ in the DDS in this study was 1.2 mg.
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Belenitsky MP, Liu C, Tsui I. Scedosporium apiospermum endopthalmitis treated early with intravitreous voriconazole results in recovery of vision. J Ophthalmic Inflamm Infect 2012; 2:157-60. [PMID: 22370908 DOI: 10.1007/s12348-012-0063-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 02/07/2012] [Indexed: 11/22/2022] Open
Abstract
Aim The purpose of this study is to report a case of endogenous endopthalmitis caused by Scedosporium apiospermum with a favorable outcome and review previously reported cases, their treatment regimens and outcomes. Methods An 83-year-old man with diabetes mellitus, no other immunocompromising risk factors, and a history of S. apiospermum endopthalmitis in the left eye developed endopthalmitis in the right eye. Within 72 h of presentation, he was treated with a pars plana vitrectomy and intravitreal voriconozole. Results Vitreous cultures confirmed S. apiospermum. The patient responded to treatment, with a favorable outcome and full recovery of vision. Conclusions Recognition of S. apiospermum endopthalmitis and appropriate early intervention with pars plana vitrectomy and intravitreal voriconozole can lead to a favorable outcome with restoration of visual acuity.
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Hu J, Ma H, Li T, Zhu X, Tang S. Retina translocation for a patient with endogenous fungal endophthalmitis: long-term follow-up. Graefes Arch Clin Exp Ophthalmol 2012; 250:1237-40. [PMID: 22331145 DOI: 10.1007/s00417-011-1858-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 10/06/2011] [Accepted: 11/02/2011] [Indexed: 10/28/2022] Open
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Eschle-meniconi ME, Guex-crosier Y, Wolfensberger TJ. Endogenous Ocular Nocardiosis—An Interventional Case Report With a Review of the Literature. Surv Ophthalmol 2011; 56:383-415. [DOI: 10.1016/j.survophthal.2011.03.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 03/09/2011] [Accepted: 03/22/2011] [Indexed: 11/19/2022]
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Walia H, Tucci VT, Greene JN, Tordilla-Wadia J, Kelty P, Walia S. A case of endogenous trichosporon endophthalmitis treated with micafungin and voriconazole. J Glob Infect Dis 2011; 1:71-4. [PMID: 20300392 PMCID: PMC2840932 DOI: 10.4103/0974-777x.52987] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Invasive fungal infections are a significant cause of morbidity and mortality. Endogenous fungal endophthalmitis is a rare intraocular infection with potential vision threatening consequences. Our review of the literature revealed only one other case of Trichosporon endophthalmitis. Ocular fungal infections are difficult to eradicate because of the limited availability of systemic and intravitreal therapeutic agents and poor tissue penetration of current antifungals. Along with systemic antifungal agents, vitrectomy and intravitreal amphotericin B have been suggested as optimal treatments for fungal endophthalmitis. Other antifungals such as flucytosine and triazoles have recently received consideration. Although the current antifungal therapy is not highly successful, there remains a significant potential for more successful treatments in the future, based on the current studies. We report a case of endogenous trichosporon endophthalmitis that was successfully treated with micafungin and voriconazole. This combination has not been previously reported as a successful therapy in literature. More targeted research is required to uncover additional efficacious therapies to combat trichosporon.
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Affiliation(s)
- Harpreet Walia
- University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., Tampa, Florida 33612, USA
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Vergoulidou M, Krause L, Foerster MH, Thiel E, Schwartz S. Endogenous filamentous fungal endophthalmitis--single-centre survey in patients with acute leukaemia or postallogeneic stem cell transplantation and review of the literature. Mycoses 2011; 54:e704-11. [PMID: 21605192 DOI: 10.1111/j.1439-0507.2010.02004.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Endogenous endophthalmitis caused by filamentous fungi has been infrequently described and its prognosis in immunocompromised patients is largely unknown. Patients were identified through a single-centre database containing patients with endophthalmitis. Cases published since 2002 were reviewed. Clinical and treatment features as well as outcomes were analysed. Six patients were identified from the database. Underlying conditions were haematological malignancies (HM) and/or allogeneic haematopoietic stem cell transplantation (HSCT). Three patients underwent vitrectomy. None of the patients survived and the median time from first evidence of endophthalmitis until death was 33 days. The median time from first evidence of an invasive fungal infection to endophthalmitis was only 5 days. Fifty-six patients were identified from the literature. The majority of these patients underwent vitrectomy (27) or enucleation (10) and received intraocular antifungal therapy (28). Only 13 (23%) of 56 patients experienced an improved vision. The survival rate was 52% in all 56 patients but was significantly less in patients with HM or post-HSCT when compared with all others (26% vs. 70%, respectively; P = 0.003). Endogenous endophthalmitis caused by filamentous fungi is frequently associated with a permanent decrease or loss of vision. This type of fungal infection carries a particular poor prognosis in patients with profound immunosuppression, requiring improved treatment strategies.
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Affiliation(s)
- Maria Vergoulidou
- Department of Hematology and Oncology, Charité-Campus Benjamin Franklin, Berlin, Germany
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Won H, Kim HR, Kim DH, Oh J, Ki JH, Han CH, Lee SM, Kim CJ. Disseminated Scedosporium apiospermumInfection Induced from Aspiration Pneumonia after Near-Drowning. Tuberc Respir Dis (Seoul) 2010. [DOI: 10.4046/trd.2010.69.4.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hoyoun Won
- Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Rae Kim
- Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Hwan Kim
- Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Jaewon Oh
- Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Hye Ki
- Department of Pathology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Chang Hun Han
- Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Sun Min Lee
- Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Cheong Ju Kim
- Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
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Abstract
BACKGROUND Intravitreal injection (IVI) with administration of various pharmacological agents is a mainstay of treatment in ophthalmology for endopthalmitis, viral retinitis, age-related macular degeneration, cystoid macular edema, diabetic retinopathy, uveitis, vascular occlusions, and retinal detachment. The indications and therapeutic agents are reviewed in this study. METHODS A search of the English, German, and Spanish language MEDLINE database was conducted. A total of 654 references spanning the period through early 2008 were individually evaluated. RESULTS The advantage of the IVI technique is the ability to maximize intraocular levels of medications and to avoid the toxicities associated with systemic treatment. Intravitreal injection has been used to deliver several types of pharmacological agents into the vitreous cavity: antiinfective and antiinflammatory medications, immunomodulators, anticancer agents, gas, antivascular endothelial growth factor, and several others. The goal of this review is to provide a detailed description of the properties of numerous therapeutic agents that can be delivered through IVI, potential complications of the technique, and recommendations to avoid side effects. CONCLUSION The IVI technique is a valuable tool that can be tailored to the disease process of interest based on the pharmacological agent selected. This review provides the reader with a comprehensive summary of the IVI technique and its multitude of uses.
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Affiliation(s)
- Gholam A Peyman
- Department of Ophthalmology and Vision Science, College of Medicine, University of Arizona, Tucson, Arizona 85351, USA.
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Vasconcelos-Santos DV, Nehemy MB. Use of voriconazole in the surgical management of chronic postoperative fungal endophthalmitis. Ophthalmic Surg Lasers Imaging Retina 2009; 40:425-31. [PMID: 19634753 DOI: 10.3928/15428877-20096030-16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Management of postoperative mycotic endophthalmitis remains challenging. This study reports successful management of postoperative chronic fungal endophthalmitis with vitrectomy surgery and voriconazole. A retrospective interventional case series of four eyes of four patients with chronic fungal endophthalmitis treated with pars plana vitrectomy and oral and intravitreal voriconazole is described. Pars plana vitrectomy, en bloc capsulectomy, and explantation of the intraocular lens were then performed combined with one to four intravitreal injections of voriconazole and oral voriconazole for up to 5 weeks. Identified fungal species included Aspergillus, Acremonium, Penicillium, and Verticillium. Voriconazole may have affected the clinical and surgical management of fungal endophthalmitis.
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Lin RC, Sanduja N, Hariprasad SM. Successful Treatment of Postoperative Fungal Endophthalmitis Using Intravitreal and Intracameral Voriconazole. J Ocul Pharmacol Ther 2008; 24:245-8. [DOI: 10.1089/jop.2007.0105] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Richard C. Lin
- Department of Ophthalmology, University of Chicago, Chicago, IL
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