| Management of Fungal Ocular Infection with Topical and Intracameral Voriconazole. |
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Kyung Hoon Kim, Myoung Joon Kim, Hungwon Tchah |
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Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. joon@amc.seoul.kr |
| 보리코나졸로 치료한 진균안감염 |
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김경훈ㆍ김명준ㆍ차흥원 |
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Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea |
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Correspondence:
Kyung Hoon Kim, M.D. |
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| Abstract |
PURPOSE
To describe the successful treatment of a series of fungal ocular infections with voriconazole. METHODS: A retrospective chart review was conducted for six eyes of five patients: four eyes of four patients with fungal keratitis, and two eyes of one patient with fungal endophthalmitis who were treated with topical and intracameral voriconazole. A battery of analyses on corneal isolates, clinical outcomes, duration of treatment, time to remission, complications, concomitant medication, and visual acuity at the initial and last visits was performed. RESULTS: Six eyes of five patients were treated in total. Three eyes with fungal keratitis were treated with 5% topical voriconazole, and infection was controlled. Therapeutic penetrating keratoplasty was performed on one eye with fungal keratitis due to impending corneal perforation; this eye was treated successfully with topical voriconazole without recurrent inflammation. Both eyes of one patient with fungal endophthalmitis were given an intracameral voriconazole (100 microgram/0.1 cc) injection twice in the right eye and once in the left eye, and infection was controlled with continued topical voriconazole therapy. There was no clinically remarkable corneal epithelial toxicity from topical application. No corneal endothelial toxicity was observed after an intracameral injection of voriconazole. CONCLUSIONS: Voriconazole is known to penetrate efficiently into ocular tissues. As shown in our case series, voriconazole is a new, promising therapy for intractable fungal ocular infection. |
| Key Words:
Fungal endophthalmitis;Fungal keratitis;Voriconazole |
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