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Aspergillus Endophthalmitis: Epidemiology, Pathobiology, and Current Treatments
Alisha Khambati1, Robert Emery Wright1, Susmita Das1
1Department of Ophthalmology, Visual and Anatomical Sciences, School of Medicine, Wayne State University, Detroit, MI 48201, USA.
Abstract:
Fungal endophthalmitis is one of the leading causes of vision loss worldwide. Post-operative and traumatic injuries are major contributing factors resulting in ocular fungal infections in healthy and, more importantly, immunocompromised individuals. Among the fungal pathogens, the Aspergillus species, Aspergillus fumigatus, continues to be more prevalent in fungal endophthalmitis patients. However, due to overlapping clinical symptoms with other endophthalmitis etiology, fungal endophthalmitis pose a challenge in its diagnosis and treatment. Hence, it is critical to understand its pathobiology to develop and deploy proper therapeutic interventions for combating Aspergillus infections. This review highlights the different modes of Aspergillus transmission and the host immune response during endophthalmitis. Additionally, we discuss recent advancements in the diagnosis of fungal endophthalmitis. Finally, we comprehensively summarize various antifungal regimens and surgical options for the treatment of Aspergillus endophthalmitis.
Insights
Fungal endophthalmitis, often caused by Aspergillus, leads to vision loss. Understanding its transmission, immune response, and diagnosis is key for effective antifungal treatments and surgical interventions.
Area of Science:
- Ophthalmology
- Mycology
- Infectious Diseases
Background:
- Fungal endophthalmitis is a significant cause of global vision loss, frequently linked to post-operative or traumatic ocular injuries.
- Immunocompromised individuals are particularly susceptible to fungal keratitis, with Aspergillus species, especially Aspergillus fumigatus, being a prevalent pathogen.
- The overlapping clinical presentation with other endophthalmitis types complicates diagnosis and treatment, necessitating a deeper understanding of its pathobiology.
Purpose of the Study:
- To review the transmission routes of Aspergillus in endophthalmitis.
- To elucidate the host immune response during fungal endophthalmitis.
- To summarize current diagnostic advancements and therapeutic strategies for Aspergillus endophthalmitis.
Main Methods:
- Literature review focusing on fungal endophthalmitis, particularly Aspergillus.
- Analysis of transmission pathways and host-pathogen interactions.
- Synthesis of recent findings on diagnostic techniques and treatment options.
Main Results:
- Aspergillus species are a leading cause of fungal endophthalmitis, posing diagnostic and therapeutic challenges.
- Understanding transmission and immune response is crucial for developing targeted interventions.
- Recent diagnostic tools and a range of antifungal and surgical treatments are available.
Conclusions:
- Effective management of Aspergillus endophthalmitis requires a comprehensive approach.
- Continued research into diagnosis and treatment is vital to mitigate vision loss.
- This review provides a consolidated overview of current knowledge and therapeutic options.
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