Intracameral Voriconazole Injection in the Treatment of Fungal Endophthalmitis Resulting From Keratitis

Am J Ophthalmol. 2010 Jun;149(6):916-21. doi: 10.1016/j.ajo.2010.01.024.

Abstract

Purpose: To report the therapeutic efficacy of intracameral voriconazole injection in the treatment of fungal endophthalmitis resulting from keratitis.

Design: Retrospective, single-institution, consecutive case series.

Methods: Microbiologic and medical records were reviewed for patients with positive intraocular culture results or proven pathologic features for fungal organisms and clinically diagnosed fungal endophthalmitis resulting from keratitis. Ten eyes were treated with an intracameral injection of 100 microg voriconazole. Clinical characteristics, treatment, and causative organisms were analyzed.

Results: Fusarium and Aspergillus were the most common causative organisms. Voriconazole was injected intracamerally from 1 to 8 times. Of the 7 patients who received 5 or more repeat injections, 6 were caused by Fusarium and 1 by Acremonium. In the remaining 3 patients who were administered 4 or fewer voriconazole injections, the causative organisms were Aspergillus and Alternaria.

Conclusions: Intracameral voriconazole injection may be an effective treatment for fungal endophthalmitis contiguously spreading from keratitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acremonium / isolation & purification
  • Adult
  • Aged
  • Alternaria / isolation & purification
  • Anterior Chamber / drug effects
  • Antifungal Agents / administration & dosage*
  • Aspergillus / isolation & purification
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / microbiology
  • Endophthalmitis / drug therapy*
  • Endophthalmitis / microbiology
  • Eye Infections, Fungal / drug therapy*
  • Eye Infections, Fungal / microbiology
  • Female
  • Fusarium / isolation & purification
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Pyrimidines / administration & dosage*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Triazoles / administration & dosage*
  • Visual Acuity / physiology
  • Voriconazole

Substances

  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole