Treatment of Bilateral Endogenous Aspergillus Endophthalmitis with Multiple Intravitreal Voriconazole Injections with

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Inas F Aboobakar1, Sally S Ong1, Akosua Nti1

  • 1Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.

Case Reports in Ophthalmology
|February 3, 2022
PubMed

Insights

Endogenous Aspergillus endophthalmitis is aggressive. This case study shows multiple intravitreal voriconazole injections effectively treated bilateral Aspergillus endophthalmitis, improving vision.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Mycology

Background:

  • Endogenous endophthalmitis caused by Aspergillus species presents a significant challenge due to its aggressive nature and potential for severe vision loss.
  • Intravitreal amphotericin B has been a historical treatment, but outcomes are variable and toxicity is a concern.

Observation:

  • A case of bilateral endogenous Aspergillus endophthalmitis is presented.
  • The patient received multiple intravitreal injections of voriconazole: 8 in the right eye and 11 in the left eye.

Findings:

  • Treatment with a high number of intravitreal voriconazole injections resulted in good final visual acuity in both eyes (20/50 OD, 20/40 OS).
  • This suggests intravitreal voriconazole can be a safe and effective treatment for severe Aspergillus endophthalmitis, even with repeated administration.

Implications:

  • These findings support the expanded use of intravitreal voriconazole for managing aggressive endogenous Aspergillus endophthalmitis.
  • Further research into optimal dosing and duration of intravitreal voriconazole therapy is warranted.
Keywords:
AspergillusEndogenous endophthalmitisIntravitreal voriconazole

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