Anne-Lise Bienvenu1,2, Marine Aussedat1, Thibaud Mathis3,4, Martin Guillaud3, Gilles Leboucher1, Laurent Kodjikian3,4. 1. Service Pharmacie, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France. 2. ICBMS CNRS 5246, Campus Lyon-Tech La Doua, Université de Lyon, Lyon, France. 3. Service d'Ophtalmologie, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France. 4. Matéis, UMR-CNRS 5510, Lyon, France.
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.
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.
Authors: Andrea Duminuco; Elisa Mauro; Giuseppe A M Palumbo; Bruno Garibaldi; Marina Parisi; Francesco Di Raimondo; Cinzia Maugeri; Calogero Vetro Journal: Hematol Rep Date: 2021-11-26