Intravitreal Injections of Voriconazole for Candida Endophthalmitis: A Case Series. (2nd April 2020)

• Record Type: Journal Article
• Authors: Bienvenu, Anne-Lise; Aussedat, Marine; Mathis, Thibaud; Guillaud, Martin; Leboucher, Gilles; Kodjikian, Laurent
• Is Part Of: Ocular immunology and inflammation. Volume 28:Number 3(2020)
• Page Start: 471
• Page End: 478
• Publication Date: 2020-04-02
• Subjects: Candida -- clinical outcome -- endophthalmitis -- intravitreal injection -- retrospective review -- safety -- voriconazole; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2019.1571613
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Purpose : Candida endophthalmitis represents a therapeutic challenge, considering the inability of many antifungals to achieve adequate concentrations in the vitreous. Intravitreal injection (IVI) of antifungals (amphotericin b deoxycholate or voriconazole) is therefore recommended. Whereas amphotericin b IVI is well documented, clinical data on voriconazole IVI are limited. Methods : This was a retrospective review IRB approved of patients receiving voriconazole IVI for Candida endophthalmitis. Complete ophthalmological examination was completed at baseline and during follow-up. Results : Five patients were treated with a mean four injections [range: 2–9] of voriconazole (100 µg/0.1 mL saline). Improvement of visual acuity and disappearance of signs of infection were obtained in all patients. Safety concern including photoreceptor toxicity was not attributed to voriconazole IVI. Conclusions : Voriconazole IVI demonstrated to be safe and led to a favorable clinical outcome. Thus, voriconazole IVI must be performed if Candida endophthalmitis is suspected to increase the chance of clinical success.