OBJECTIVE: To describe the first use of intravitreal voriconazole in a human eye for the treatment of Aspergillus endophthalmitis. DESIGN: Interventional case report. PATIENT: A 22-year-old woman receiving immunosuppressive agents 5 weeks after lung transplantation who presented with blurred vision and redness in the right eye. INTERVENTIONS: Intravitreal injection of voriconazole (100 microg/0.1 ml) with pars plana vitrectomy, given after isolation of A. terreus in the vitreous sample. Previous treatment modalities, including vitrectomy with repeated intravitreal amphotericin B and systemic voriconazole, failed to prevent deterioration. MAIN OUTCOME MEASURES: Visual acuity (VA) and ocular inflammation. RESULTS: Significant improvement was observed in VA (to 6/15) and in ocular inflammatory reaction. The patient recovered with no evidence of systemic fungal infection. CONCLUSION: Intravitreal voriconazole may be used as an adjunct to systemic treatment in patients with Aspergillus endophthalmitis. Further clinical studies are needed to determine how often this approach can safely treat this condition.
OBJECTIVE: To describe the first use of intravitreal voriconazole in a human eye for the treatment of Aspergillus endophthalmitis. DESIGN: Interventional case report. PATIENT: A 22-year-old woman receiving immunosuppressive agents 5 weeks after lung transplantation who presented with blurred vision and redness in the right eye. INTERVENTIONS: Intravitreal injection of voriconazole (100 microg/0.1 ml) with pars plana vitrectomy, given after isolation of A. terreus in the vitreous sample. Previous treatment modalities, including vitrectomy with repeated intravitreal amphotericin B and systemic voriconazole, failed to prevent deterioration. MAIN OUTCOME MEASURES: Visual acuity (VA) and ocular inflammation. RESULTS: Significant improvement was observed in VA (to 6/15) and in ocular inflammatory reaction. The patient recovered with no evidence of systemic fungal infection. CONCLUSION: Intravitreal voriconazole may be used as an adjunct to systemic treatment in patients with Aspergillus endophthalmitis. Further clinical studies are needed to determine how often this approach can safely treat this condition.
Authors: Yoshihiro Inamoto; Igor Petriček; Linda Burns; Saurabh Chhabra; Zachariah DeFilipp; Peiman Hematti; Alicia Rovó; Raquel Schears; Ami Shah; Vaibhav Agrawal; Aisha Ahmed; Ibrahim Ahmed; Asim Ali; Mahmoud Aljurf; Hassan Alkhateeb; Amer Beitinjaneh; Neel Bhatt; Dave Buchbinder; Michael Byrne; Natalie Callander; Kristina Fahnehjelm; Nosha Farhadfar; Robert Peter Gale; Siddhartha Ganguly; Shahrukh Hashmi; Gerhard C Hildebrandt; Erich Horn; Ann Jakubowski; Rammurti T Kamble; Jason Law; Catherine Lee; Sunita Nathan; Olaf Penack; Ravi Pingali; Pinki Prasad; Drazen Pulanic; Seth Rotz; Aditya Shreenivas; Amir Steinberg; Khalid Tabbara; André Tichelli; Baldeep Wirk; Jean Yared; Grzegorz W Basak; Minoo Battiwalla; Rafael Duarte; Bipin N Savani; Mary E D Flowers; Bronwen E Shaw; Nuria Valdés-Sanz Journal: Biol Blood Marrow Transplant Date: 2018-12-03 Impact factor: 5.742