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Original Article

Intravitreal Injections of Voriconazole for Candida Endophthalmitis: A Case Series

, PharmD, PhD, , PharmD, , MD, , MD, , PharmD & , MD, PhD
Pages 471-478 | Received 12 Oct 2018, Accepted 15 Jan 2019, Published online: 27 Feb 2019
 

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.

DISCLOSURE STATEMENT

The authors report no conflicts of interest. The authors alone are responsible for the conduct and writing of the article.

Additional information

Funding

None

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