Topical and oral voriconazole in the treatment of fungal keratitis

Am J Ophthalmol. 2007 Jan;143(1):151-3. doi: 10.1016/j.ajo.2006.07.033. Epub 2006 Aug 31.


Purpose: To describe nine patients with fungal keratitis refractory to standard antifungal therapy whose condition was managed with voriconazole.

Design: 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.

Conclusion: Voriconazole is a new, promising therapy for fungal keratitis that is refractory to standard antifungal treatments.

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Adult
  • Aged
  • Aged, 80 and over
  • Antifungal Agents / therapeutic use*
  • Eye Infections, Fungal / drug therapy*
  • Eye Infections, Fungal / microbiology
  • Female
  • Fungi / isolation & purification
  • Humans
  • Keratitis / drug therapy*
  • Keratitis / microbiology
  • Male
  • Middle Aged
  • Mycoses / drug therapy*
  • Mycoses / microbiology
  • Pyrimidines / therapeutic use*
  • Retrospective Studies
  • Triazoles / therapeutic use*
  • Voriconazole


  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole